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Diabetes Technologies in Ultra-Endurance Type 1 Diabetes: Qualitative Study.
Jean-Charles Vauthier1,2, Lucie Choley1, Delphine Arduini3
1Faculty of Medicine, Maieutics and Health Professions, Université de Lorraine, 9 avenue de la Forêt de Haye, BP 20199, Vandoeuvre Lès Nancy, 54505, France, 33 0687701621.
Journal of Medical Internet Research
|May 8, 2026
Summary
Diabetes technologies enable participation in ultra-endurance sports but increase cognitive and organizational demands. Athletes develop robustness-in-use through redundancy and adaptive know-how to manage these challenges.
Area of Science:
- Digital health
- Human-computer interaction
- Qualitative research
Background:
- Diabetes technologies like continuous glucose monitoring (CGM), insulin pumps, and hybrid closed-loop systems have transformed type 1 diabetes (T1D) management.
- Their application in ultra-endurance sports presents unique, underexplored challenges in cognitive, material, and organizational aspects.
Purpose of the Study:
- To explore the experiences of adults with T1D using diabetes technology during ultra-endurance sports.
- To investigate the interplay between autonomy, mental load, and vulnerability in this context.
Main Methods:
- Semistructured interviews with 13 French-speaking adults with T1D who participated in ultra-endurance events.
- Constructivist grounded theory methodology, including iterative coding and constant comparison.
- Participant recruitment via associations and online communities, with patient partner involvement.
Main Results:
- Five categories emerged: shifting glucose management to continuous anticipation, perceived gains in safety and performance, redistributed mental workload, managing technological fragility through improvisation, and technology's role in identity and stigma.
- A key tension identified was between performance optimization and user-constructed robustness, emphasizing redundancy and adaptive expertise.
- Participants highlighted the need for "robustness-in-use" to maintain function under uncertainty.
Conclusions:
- Diabetes technologies in ultra-endurance are both enablers and sources of increased cognitive/organizational work.
- Findings offer practical implications for clinicians, designers, and policymakers regarding support and education for athletes with T1D.
- Practice-oriented research is valuable for informing digital health design and support for chronic illness management.
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