'Royal College of Obstetricians & Gynaecologists (RCOG)'
Abstract
The purpose of this study is to characterise the decision-making and self-management strategies of individuals with Type 1 diabetes (T1D) participating in a 150-mile ultra-endurance cycling event and inform Healthcare Professionals working in T1D. Participation in ultra-endurance exercise is becoming increasingly popular in the T1D community and self-management in this context needs further investigation. Qualitative, semi-structured interviews were conducted with 12 participants with T1D who took part in the ‘Coast to Coast in a Day’ cycling sportive. Event-specific and T1D self-management strategies in the context of endurance exercise were assessed using the Thematic Network Approach to analysis. Participants reported that they took part in the event "as a cyclist rather than a Type 1 diabetic". A range of self-management strategies to manage glycaemic control were identified, but all were grounded in experience of a "trial-and-error" approach to determine "successful practice". Engagement with Healthcare Professionals in preparation for the event was limited due to a perceived lack of endurance exercise knowledge. Participants reflected that T1D can be controlled in ultra-endurance events through careful and practised self-management of energy intake and insulin strategies. Individuals with T1D are capable of taking part and excelling in ultra-endurance events, but current Healthcare Professional advice does not match patient ambition and practice, which is grounded in an identity that is first and foremost as a ‘cyclist and person’. Limitations in participants’ "trial-and-error" practices require further understanding from Healthcare Professionals to provide advice around existing knowledge, preparation and self-management strategies for ultra-endurance exercise.N
