It is the demanding environment of a World Cup tournament and a professional footballer’s life that makes Spanish defender Nacho’s story so impressive and heart-warming, especially on the back of the 28 year-old’s performance during his nation’s first game in the World Cup.
Having already been on the books of Real Madrid for two years, a 12 year-old Nacho was taken to see a doctor by his concerned mother who noticed that her son was becoming increasingly thirsty and passing lots of urine.
Nacho’s blood glucose level was noted to be sky high and he was soon given the dreadful news that he has to give up soccer as a consequence of his diagnosis of Type I Diabetes Mellitus.
Born and raised in Alcala de Henares, just 20 miles east of Madrid, his lifelong goal was to play in the famous white shirt of Los Blancos. Having received the news a few days before a soccer tournament, his dream had suddenly turned into a nightmare.
It was a visit to Dr Ramirez, an endocrinologist, that changed Nacho’s life. Dr Ramirez explained that diabetes, even at such a young age, should not be a deterrent to competitive sport. Actually, the opposite is true in that regular exercise is very beneficial to such patients. However, compliance to his treatment, namely insulin, was, and still is, of paramount importance.
The term “diabetes mellitus” was coined in the 17th century by the British doctor Thomas Willis. “Diabetes” is derived from Ancient Greek and literally means “to pass through”, a reference to the high urine output individuals having the condition may have. “Mellitus” comes from the classical Latin word meaning “honey-sweet” referring to the high sugar (or glucose to be exact) content in the urine.
Insulin is a hormone made of protein that regulates blood sugar levels. If the body senses high sugar levels, the production of insulin is stimulated. Insulin acts by distributing the glucose in the blood into cells such as those in the liver and muscle. These cells act as a storage space for when glucose is then required quickly by the body such as during exercise or when starving.
Insulin is produced in the pancreas, specifically in the beta cells. Diabetes Mellitus actually refers to a defect in this above mentioned process. It can be broadly divided into two: (1) either little or no insulin is being produced by the pancreas, or (2) the body is resistant or insensitive to the insulin that is produced.
Constantly high levels of blood glucose are harmful to the body both short term and in the long term. In the short term, the kidneys are unable to cope with such high glucose levels and consequently the urine produced has a high concentration of glucose. This abnormal concentration gradient pulls water outside the kidneys which explains the excessive thirst and high urine output such patients may experience.
In the long term, poorly controlled glucose levels result in diseased blood vessels resulting in a higher risk of strokes, heart disease and circulatory problems in the limbs. Small vessels are especially at risk, resulting in disease in the kidneys, eyes and throughout the nervous system.
Obesity actually can render the body insensitive to insulin which explains the high rate of diabetes mellitus type II in the western world.
However, in diabetes mellitus type I, which is Nacho’s diagnosis, insulin levels are scarce or possibly even negligible due to the pancreas not producing sufficient levels. The only way this can be corrected, apart from a pancreatic transplant, is to actually provide the patient with insulin which is administered through the skin through a tiny needle.
Various insulin regimes and products are available, but a strict diet and exercise regime is essential to ensure that the glucose level does not fluctuate greatly. An ensuing low level of glucose can be equally dangerous, especially when performing activities such as swimming and driving.
A typical diabetic “kit” would include insulin and the pen to administer it, as well as sugar-checking devices and rescue medications that increase the glucose quickly in the event of a hypoglycaemic attack (i.e when the glucose level drops to worrying levels).
Put in the intensity and grueling exercise regimes that come in with modern soccer and you have Nacho, a soccer World Cup star who is an inspiration to young patients all around the world.
His beautiful strike, and the international recognition that came with it, against Portugal during the exhilarating 3-3 draw on Friday is a fitting reward for the defender, fresh from winning his fourth European Champions League title with his boyhood club.
Such success is a reflection of his determination and positive attitude. This has made him a firm favourite with the notoriously impatient Real Madrid fans and virtually undroppable in a multi-talented Spanish international team.