Experiential knowledge and peer support in type 1 diabetes: insights from endurance running communities

Managing type 1 diabetes (T1D) during endurance running requires highly individualized strategies, yet conventional healthcare offers limited sport-specific guidance. Peer communities have emerged as key sources of experiential knowledge, emotional support, and practical tools.

To explore how endurance runners with T1D build self-management strategies, use peer networks and digital platforms, and integrate these exchanges into identity and daily life.

Thirteen French-speaking adults with T1D who had completed at least one marathon or ultra-endurance event participated in semi-structured interviews. Data were analyzed using constructivist grounded theory. Two patient contributors living with T1D supported interpretation and writing. COREQ guidelines were followed.

Peer communities operated as informal educational systems that transformed individual trial-and-error into shared, actionable knowledge. Digital platforms provided rapid troubleshooting, reflective tools, and distributed mentorship. Role models facilitated confidence, self-efficacy, and identity reconstruction. Despite strong collective dynamics, management remained highly individualized through context-aware "micro-protocols" developed via safe experimentation and peer comparison.

Peer communities play a central role in translating clinical recommendations into real-world endurance strategies. Integrating peer mentoring, digital literacy, and structured reflective practice into patient education may enhance personalization and confidence for people living with T1D.

This study demonstrates how communities of practice and digital infrastructures can support experiential learning in high-variability contexts and illustrates the contribution of patient partners to qualitative analysis and manuscript co-construction.

Two individuals living with T1D contributed to interpretation and writing, ensuring relevance and accessibility for the patient community.