Marathon runners conquer type 1 diabetes with new tech, while exercise fears persist for many
Advancements in glucose monitoring and insulin delivery systems are enabling people with type 1 diabetes to participate in demanding physical activities, while fear of hypoglycaemia remains a significant barrier to exercise for many.
Two new studies presented at the Annual Meeting of The European Association for the Study of Diabetes (EASD) in Madrid highlight both the progress and ongoing challenges in diabetes management. The research, presented as Posters at the event, explore the use of advanced hybrid closed-loop technology for marathon runners and the persistent fear of hypoglycaemia among adults with type 1 diabetes.
Enabling marathon success with automated insulin delivery
A series of case reports describe how three adults with type 1 diabetes successfully completed marathons in Tokyo, Santiago, and Paris using an advanced hybrid closed-loop (AHC) system. This technology automates both basal and correction bolus insulin delivery every 5 minutes based on continuous glucose monitoring data.
Dr Maria Onetto from Pontificia Universidad Católica Chile, the lead author of the study, stated: “It is great to see advances in diabetes technology come to fruition and deliver such improvements to people’s lives. This technology is game changing, allowing more people with diabetes to have safer, healthier, more active lives.”
The study focused on three individuals:
- A 50-year-old man with a 22-year history of type 1 diabetes completed the Tokyo Marathon in 3 hours and 34 minutes. During the race, he maintained 96% of his time within the target glucose range, with an average blood glucose of 107 mg/dL.
- A 40-year-old man diagnosed with type 1 diabetes four years prior finished the Santiago Marathon in 4 hours and 56 minutes. Remarkably, he spent 100% of the marathon within the target glucose range, with an average blood glucose of 110 mg/dL.
- A 34-year-old woman living with type 1 diabetes for 27 years completed the Paris Marathon in 3 hours and 56 minutes. However, she remained hyperglycaemic throughout the race, with an average blood glucose of 271 mg/dL.
The researchers emphasised the importance of personalised approaches and specialised education for athletes using automated insulin delivery systems during intense physical activities.
Fear of hypoglycaemia persists despite technological advances
While technology has made significant strides in diabetes management, a separate study reveals that fear of hypoglycaemia remains a major obstacle to physical activity for many adults with type 1 diabetes.
Dr Catriona Farrell from the University of Dundee led a team that surveyed 463 adults with type 1 diabetes to assess barriers to physical activity. The study found that despite high usage of continuous glucose monitoring (79%) and insulin pump therapy (36%), the risk of hypoglycaemia during exercise continues to be a significant concern.
Overcoming barriers through education and clinical support
The research identified several factors that could help mitigate this fear:
- Understanding insulin adjustments: Participants who better understood how to adjust insulin doses and carbohydrate intake for exercise reported less fear of hypoglycaemia.
- Clinical discussions: Being asked about exercise or sport within a diabetes clinic was negatively correlated with fear of hypoglycaemia.
- Exercise confidence: This was identified as the strongest independent predictor of fear of physical activity.
Dr Farrell commented: “Our findings demonstrate that in order to break down the barriers to physical activity, and empower our patients to exercise safely and effectively, we need to improve the education we provide and our dialogue about exercise in clinics.”
Implications for diabetes care
Both studies underscore the importance of personalised approaches to diabetes management, especially when it comes to physical activity. While advanced technologies like hybrid closed-loop systems can provide significant benefits, addressing psychological barriers through education and clinical support remains crucial.
As diabetes care continues to advance, these findings suggest that a holistic approach combining technological solutions with targeted education and support may be key to helping individuals with type 1 diabetes lead active, healthy lives.
The research highlights the need for healthcare professionals to engage in ongoing discussions about exercise and diabetes management with their patients, potentially leading to reduced fear of hypoglycaemia and increased participation in physical activities.
