A new study published in the Clinical Diabetes highlights a gap in diabetes self-management education for physically active adults with type 1 diabetes (T1D). Surveying 102 regular exercisers from online T1D communities, researchers found that while participants were highly engaged in physical activity and used diabetes technologies, hypoglycemia during and after exercise remained a common and serious issue.

Despite meeting or exceeding aerobic exercise guidelines, 86% of respondents reported experiencing exercise-related hypoglycemia, and 41% experienced overnight hypoglycemia. 18% had severe hypoglycemic episodes during exercise, and 10% experienced diabetic ketoacidosis (DKA) following physical activity, both of which are potentially life-threatening complications.

Most participants did not adhere to established glucose management guidelines. Only 27% of insulin pump users adjusted basal insulin before exercise, and just 42% used their pump's exercise mode during workouts. Fewer than a third restricted exercise following a severe hypoglycemic event, despite consensus recommendations.

The study also revealed a heavy reliance on non-medical sources for diabetes education. While 80% of participants turned to trial and error, social media, or internet searches for managing glucose during exercise, only 32% identified their healthcare providers as key sources of information.

49% of participants reported not feeling symptoms of hypoglycemia unless their blood sugar dropped below 60 mg/dL (3.3 mmol/L).