Dizon Stephanie, Malcolm Janine, Rowan Margo, Keely Erin J
University of Ottawa, Department of Medicine, Division of Endocrinology & Metabolism, Ottawa, Ontario, Canada.
The Ottawa Hospital, Ottawa, Ontario, Canada.
Diabetes Spectr. 2019 Feb;32(1):36-45. 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.
1型糖尿病运动员面临着独特的挑战，这使得医疗保健提供者难以提供关于糖尿病管理的简明建议。此外，对于高水平竞技运动期间患者在糖尿病管理方面的偏好知之甚少。我们进行了一项定性研究，以了解患者在运动期间管理1型糖尿病的观点。
选择采用焦点小组的定性设计。每组招募5至10名参与者样本，参加三个1.5小时课程中的一个，课程重点是糖尿病管理经验、支持措施和所需资源。课程进行录音并逐字转录。团队成员对数据进行反复分析。
该研究纳入了21名参与者（10名男性和11名女性），平均年龄为41岁。大多数参与者在运动前后通过反复试验来管理血糖。频繁监测血糖是一种常见策略，也是运动期间的一项挑战。运动后低血糖和运动期间肾上腺素引发的高血糖是最普遍的问题。大多数参与者依靠自己、内分泌科医生或互联网获取支持，但表示他们更希望更多地依靠1型糖尿病同伴和移动应用程序。同伴支持或指导得到了强烈支持，并提出了未来发展的建议。
本研究强调了运动员血糖控制平衡的个体化性质以及运动员在制定策略方面的高度自我依赖。扩大同伴指导和移动应用程序等资源的可用性可能会为1型糖尿病运动员提供支持。
