The specific challenges and problems associated with exercise and T1D have not been formally evaluated in young people with T1D. This study was conducted using focus group methodology to understand how youth with T1D manage exercise. A purposefully selected sample of adolescents and young adults (AYA) aged 13-25 yrs (n=50) and their parents participated. Data were transcribed and analyzed inductively using NVivo software.
Study results confirmed that exercise is a major challenge for AYA with T1D, and gaps in information available to safely deal with this were identified. AYA and parents both identified their main challenge as maintaining a stable BGL during exercise. Thematic analysis characterized the barriers to exercise into physical and psychosocial factors. Other data were grouped into ‘what works’, ‘what’s needed’ and ‘where to get information’ to improve exercise management. Swimming and hypoglycemia, especially in cold water, were highlighted as specific physical challenges. Psychosocial challenges included: being defined by diabetes and hence not being treated equally, letting the sports team down and poor performance associated with unstable BGL’s, and having to deal with other people’s lack of knowledge about T1D. Intrapersonal skills that enhanced outcomes included being confident in their own decisions, taking consistent responsibility for themselves and developing good self-knowledge. Parents described their main challenge as knowing how to transfer the responsibility for T1D management from themselves to their adolescent child. All participants identified a range of ways they would like to receive information or support for managing T1D when active, including mentors, same-age support groups, informal networks, camps, workshops, mobile in-the-moment apps and at clinic.
Patient perspectives from this study will inform the direction of future research in this area, and contribute to the development of physical activity guidelines to exercise safely that meet the needs of AYA with T1D and their parents.