Demographic and clinical characteristics of a Spanish population of people living with type 1 diabetes who practice nonprofessional sports: The DIABESPORT survey

  • Author Footnotes
    1 Both authors contributed equally to this study.
    Manuel A. Gargallo-Fernández
    Corresponding author at: Department of Endocrinology and Nutrition, Hospital Universitario Infanta Leonor, Madrid, Spain.
    1 Both authors contributed equally to this study.
    Department of Endocrinology and Nutrition, Hospital Universitario Infanta Leonor, Madrid, Spain

    Department of Endocrinology and Nutrition, Fundación Jiménez Díaz, Madrid, Spain
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally to this study.
    Cristina Tejera-Pérez
    1 Both authors contributed equally to this study.
    Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Ferrol (CHUF/SERGAS), A Coruña, Spain

    Epigenomics in Endocrinology and Nutrition Group, Epigenomics Unit, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago de Compostela (CHUS/SERGAS), Santiago de Compostela, Spain
    Search for articles by this author
  • Javier Escalada-San Martin
    Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Spain

    CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN) , Spain

    Instituto de Salud Carlos III, Madrid, Spain
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally to this study.
Published:October 30, 2022DOI:



      To determine the characteristics of people with type 1 diabetes mellitus (T1D) who practice sports, the support they receive, and the way in which they manage their disease during sports.


      An observational cross-sectional study designed as a web-based survey released through social media was carried out, directed to physically active people with T1D.


      A total of 342 subjects completed the survey (16 children; 67.5% males). The duration of living with T1D was 18.6 ± 11.4 years. The mean glycosylated hemoglobin concentration (HbA1c) was 6.7 ± 0.8%, and the mean time in range (TIR) was 72.9 ± 15.8%. Only 27.2% started sports activity following the diagnosis of T1D. The most frequently used basal insulin was insulin degludec (38.6%). The usual treatment modification before doing sports consisted of bolus reduction (42.5%) or only the adjustment of nutritional supplements (19.7%). In cases of long-acting insulin users, the basal dose usually remained unchanged during sports. One-quarter of the participants were insulin pump users, and of these, 12.5% always disconnected the pump during physical activities. Severe hypoglycemia on the day of physical activity was experienced by 5% of the participants in the last 6 months. One-third reported a lack of support from their physician, and 61% had learned to manage glycemic control during sports by themselves.


      This study highlights the adjustments made by people living with T1D during sports practice, and the lack of support received from healthcare professionals.

      Graphical abstract



      AEDD (Asociación Española para el Deporte con Diabetes (Spanish Association for Sports with Diabetes)), AT1D (Active people with type 1 diabetes who practice sports), BMI (Body mass index), CSII (Continuous subcutaneous insulin infusion), MID (Multiple insulin doses), PA (physical activity), SD (Standard deviation), TBR (Time below range), TIR (Time in range), T1D (Type 1 diabetes mellitus)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Diabetes Research and Clinical Practice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Encuesta de Hábitos Deportivos en España [Internet]. [cited 2022 Mar 12]. Available from:

        • Brazeau A.S.
        • Leroux C.
        • Mircescu H.
        • Rabasa-Lhoret R.
        Physical activity level and body composition among adults with type 1 diabetes.
        Diabet Med J Br Diabet Assoc. 2012 Nov; 29: e402-e408
        • Chimen M.
        • Kennedy A.
        • Nirantharakumar K.
        • Pang T.T.
        • Andrews R.
        • Narendran P.
        What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review.
        Diabetologia. 2012 Mar; 55: 542-551
        • Riddell M.C.
        • Scott S.N.
        • Fournier P.A.
        • Colberg S.R.
        • Gallen I.W.
        • Moser O.
        • et al.
        The competitive athlete with type 1 diabetes.
        Diabetologia. 2020 Aug; 63: 1475-1490
        • Dizon S.
        • Malcolm J.
        • Rowan M.
        • Keely E.J.
        Patient Perspectives on Managing Type 1 Diabetes During High-Performance Exercise: What Resources Do They Want?.
        Diabetes Spectr Publ Am Diabetes Assoc. 2019 Feb; 32: 36-45
        • Colberg S.R.
        • Kannane J.
        • Diawara N.
        Physical Activity, Dietary Patterns, and Glycemic Management in Active Individuals with Type 1 Diabetes: An Online Survey.
        Int J Environ Res Public Health. 2021 Sep 3; 18: 9332
        • Prévost M.S.
        • Rabasa-Lhoret R.
        • Talbo M.K.
        • Yardley J.E.
        • Curry E.G.
        • Brazeau A.S.
        Gender Differences in Strategies to Prevent Physical Activity-Related Hypoglycemia in Patients With Type 1 Diabetes: A BETTER Study.
        Diabetes Care. 2022 Mar 1; 45: e51-e53
      2. Kennedy A, Narendran P, Andrews RC, Daley A, Greenfield SM, EXTOD Group. Attitudes and barriers to exercise in adults with a recent diagnosis of type 1 diabetes: a qualitative study of participants in the Exercise for Type 1 Diabetes (EXTOD) study. BMJ Open. 2018 Jan 24;8(1):e017813.

      3. Informe España 2011 – Informe España [Internet]. [cited 2022 Apr 10]. Available from:

        • Beato-Víbora P.
        • Chico-Ballesteros A.
        • Giménez M.
        • Guerrero-Vázquez R.
        • Barrio-Castellanos R.
        • Goñi-Iriarte M.J.
        • et al.
        A national survey on the efficacy and safety of continuous subcutaneous insulin infusion in patients with type 1 diabetes in Spain.
        Diabetes Res Clin Pract. 2018 Mar; 137: 56-63
        • Gómez-Peralta F.
        • Menéndez E.
        • Conde S.
        • Conget I.
        Novials A, investigators of the studies SED and SED1. Clinical characteristics and management of type 1 diabetes in Spain. The SED1 study.
        Endocrinol Diabetes Nutr. 2021 Nov; 68: 642-653
        • Scott S.N.
        • Fontana F.Y.
        • Cocks M.
        • Morton J.P.
        • Jeukendrup A.
        • Dragulin R.
        • et al.
        Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement.
        Lancet Diabetes Endocrinol. 2021 May; 9: 304-317
      4. Gargallo-Fernández M, Escalada-San Martín J, Chico-Ballesteros A, Lecumberri-Pascual E, Tejera-Pérez C, Fernández-García JC, et al. Executive summary of the consensus statement of: Clinical recommendations for sport practice in people with diabetes (RECORD Guide). Update 2021. Diabetes Mellitus Area of the Spanish Society of Endocrinology and Nutrition (SEEN). Endocrinol Diabetes Nutr. 2021 Sep 3;S2530-0164(21)00187-7.

        • Aronson R.
        • Li A.
        • Brown R.E.
        • McGaugh S.
        • Riddell M.C.
        Flexible insulin therapy with a hybrid regimen of insulin degludec and continuous subcutaneous insulin infusion with pump suspension before exercise in physically active adults with type 1 diabetes (FIT Untethered): a single-centre, open-label, proof-of-concept, randomised crossover trial.
        Lancet Diabetes Endocrinol. 2020 Jun; 8: 511-523
        • Muñoz Fabra E.
        • Díez J.L.
        • Bondia J.
        • Laguna Sanz A.J.
        A Comprehensive Review of Continuous Glucose Monitoring Accuracy during Exercise Periods.
        Sensors. 2021 Jan 12; 21: E479
        • Bohn B.
        • Herbst A.
        • Pfeifer M.
        • Krakow D.
        • Zimny S.
        • Kopp F.
        • et al.
        Impact of Physical Activity on Glycemic Control and Prevalence of Cardiovascular Risk Factors in Adults With Type 1 Diabetes: A Cross-sectional Multicenter Study of 18,028 Patients.
        Diabetes Care. 2015 Aug; 38: 1536-1543
        • Knight C.
        • Lowe R.
        • Edwards M.
        • Yardley J.
        • Bain S.
        • Bracken R.
        Type 1 diabetes and physical activity: An assessment of knowledge and needs in healthcare practitioners.
        J Diabetes Nurs. 2016; 20: 271-277
        • Moser O.
        • Riddell M.C.
        • Eckstein M.L.
        • Adolfsson P.
        • Rabasa-Lhoret R.
        • van den Boom L.
        • et al.
        Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA).
        Diabetologia. 2020 Dec; 63: 2501-2520
        • Riddell M.C.
        • Gallen I.W.
        • Smart C.E.
        • Taplin C.E.
        • Adolfsson P.
        • Lumb A.N.
        • et al.
        Exercise management in type 1 diabetes: a consensus statement.
        Lancet Diabetes Endocrinol. 2017; 5: 377-390
        • Riddell M.C.
        • Shakeri D.
        • Scott S.N.
        A Brief Review on the Evolution of Technology in Exercise and Sport in Type 1 Diabetes: Past, Present, and Future.
        Diabetes Technol Ther. 2022; 24: 289-298