Patient Perspectives on Managing Type 1 Diabetes During High-Performance Exercise: What Resources Do They Want?

• Published in: Diabetes spectrum 2019-02, Vol.32 (1), p.36-45
• Main Authors: Dizon, Stephanie, Malcolm, Janine, Rowan, Margo, Keely, Erin J
• Format: Article
• Language: English
• Subjects: Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); Epinephrine; Exercise; Glucose monitoring; Hyperglycemia; Hypoglycemia
• ISSN: 1040-9165; 1944-7353
• DOI: 10.2337/ds18-0016

Athletes with type 1 diabetes face unique challenges that make it difficult for health care providers to offer concise recommendations for diabetes management. Moreover, little is known about patient preferences for diabetes management during high-level and competitive exercise. We undertook a qualitative study to understand patient perspectives on managing type 1 diabetes during exercise. A qualitative design using focus groups was selected. Samples of 5-10 participants per group were recruited to participate in one of three 1.5-hour sessions focusing on experiences in managing diabetes, supports, and desired resources. Sessions were audiotaped and transcribed verbatim. Data were analyzed iteratively among team members. The study included 21 participants (10 male and 11 female) with a mean age of 41 years. Most participants used trial and error to manage their blood glucose around exercise. Frequent monitoring of blood glucose was a common strategy and a challenge during exercise. Hypoglycemia after exercise and adrenaline-fueled hyperglycemia during exercise were the most prevalent concerns. Most participants relied on themselves, an endocrinologist, or the Internet for support but said they would prefer to rely more on peers with type 1 diabetes and mobile apps. Peer support or mentorship was strongly supported with recommendations for moving forward. This study highlights the individualized nature of balancing glycemic control in athletes and athletes' heavy self-reliance to develop strategies. Expanding the availability of resources such as peer mentoring and mobile apps could potentially support athletes with type 1 diabetes.