Author(s): PEDERSEN, S., MORTENSEN, J.F., BACH, E., JOHANSEN, R.F., VESTERGAARD, E.T., Institution: STENO DIABETES CENTER AARHUS, AARHUS UNIVERSITY HOSPITAL, AARHUS, DENMARK, Country: DENMARK, Abstract-ID: 2089

INTRODUCTION:
Exercise induces distinct glycemic responses across training modalities in individuals with type 1 diabetes (T1D). Endurance-based activities are generally associated with reductions in blood glucose, whereas explosive sports are more often associated with increases. In comparison, high-intensity interval training (HIIT) and resistance training tend to produce more variable or moderate glycemic responses. Managing these modality-specific glycemic fluctuations may contribute to diabetes-related distress in athletes with T1D. However, it remains unclear whether diabetes-related distress differs systematically according to primary training modality. Therefore, the primary aim of this cross-sectional study was to examine differences in diabetes-related distress across primary training modalities in athletes with T1D, with secondary analyses evaluating general well-being and the role of glycemic control.
METHODS:
This cross-sectional study included 150 athletes with T1D, ranging from amateur to international class, enrolled in the Clinic for Athletes with Type 1 Diabetes at Steno Diabetes Center Aarhus, Denmark. Participants were categorized by primary training modality: endurance (n=101), explosive (n=7), HIIT (n=26), or resistance (n=16). Diabetes-related distress was assessed using the Problem Areas in Diabetes (PAID) questionnaire, and general well-being was assessed using the World Health Organization-5 Well-Being Index (WHO-5). Glycemic control was assessed using glycated hemoglobin (HbA1c). Differences across training modalities were evaluated using linear models, with additional analyses adjusted for HbA1c. Pairwise comparisons were conducted based on HbA1c-adjusted models.
RESULTS:
Consistent across analyses, lower PAID scores, indicating lower diabetes-related distress, were observed among endurance and HIIT athletes, whereas significantly higher PAID scores were observed among athletes engaged in explosive sports. Significantly higher WHO-5 scores, indicating better well-being, were observed among endurance athletes compared with athletes engaged in explosive sports and resistance training. HbA1c was independently and positively associated with PAID but not with WHO-5.
CONCLUSION:
Diabetes-related distress appears to vary by training modality in athletes with T1D, with higher distress observed among athletes engaged in explosive sports compared with endurance and HIIT athletes, independent of glycemic control. In parallel, athletes engaged in explosive sports and resistance training appear to report lower general well-being. These findings may be relevant to athletic performance in athletes with T1D, as psychological burden and diabetes self-management are integral components of training and competition. Future studies should explore whether sport-specific demands differentially influence these factors.