Diabetes Mellitus and Long-Distance Running: A Systematic Review
Lorin Braschler1, Mabliny Thuany2, Thomas Züger3,4
1Faculty of Medicine, University of Bern, Bern, Switzerland.
Sports Medicine - Open
|August 2, 2026
Summary
Athletes with diabetes can safely complete endurance events like marathons with proper preparation. Continuous glucose monitoring (CGM) and insulin management are key for glycemic control during long-distance running.
Area of Science:
- Endocrinology
- Sports Medicine
- Exercise Physiology
Background:
- Growing participation of athletes with diabetes in endurance running.
- Technological advancements like continuous glucose monitoring (CGM) aid glycemic control.
- Lack of comprehensive reviews on this topic.
Purpose of the Study:
- Identify prevalence of long-distance runners with diabetes.
- Analyze their performance metrics.
- Examine blood glucose monitoring and glycemic control strategies.
Main Methods:
- Systematic literature search across major databases (PubMed, Scopus, etc.) until April 2024.
- Inclusion of original research, case reports in English/German.
- Eligibility criteria: diabetes diagnosis, endurance events (half-marathon+), exclusion of prediabetes/gestational diabetes.
Main Results:
- 22 studies included 99 runners (99% Type 1 diabetes).
- CGM used by 50%, insulin pumps by 27.2%, multiple daily injections by 63.6%.
- Weighted mean HbA1c 7.4%; time-in-range varied by race distance; asymptomatic late-onset hypoglycemia reported in 27 runners.
Conclusions:
- Athletes with diabetes can safely participate in endurance events, including ultra-marathons.
- Proper preparation and multidisciplinary support are crucial.
- Stable glycemic control is achievable with appropriate management strategies.
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