Domesticating the condition: Design lessons gained from a marathon on how to cope with barriers imposed by type 1 diabetes

Abstract

Through analytical autoethnographic analysis of marathon preparation, this study examines challenges faced by people with Type 1 Diabetes (T1D) who engage in high-performance sports. Autoethnographer and second-person perspectives (T1D runners, family members, and health providers) were collected through introspective activities (autoethnographic diary and in-depth interviews) to understand the T1D runner’s coping experience. Six insights involved in T1D self-management were identified and analyzed with reference to related design tools (prototyping, archetyping and journey mapping). Finally, we conclude with a discussion of how endurance physical activity (PA) such as running helps to “domesticate” T1D, a term coined to reflect the difficulties that T1D presents for PA accomplishment and how T1D runners’ experiences give them an opportunity to overcome PA barriers promoting physical culture and enriching further health psychology studies.

The role and need for psychological support in the treatment of adolescents and young people suffering from type 1 diabetes

“…According to Czenczek-Lewandowska et al ( 2018), regular physical exercise not only reduces the risk of secondary comorbidities but also influences maintaining blood glucose levels within range and promotes general wellbeing. At the same time, the study performed by Montt-Blanchard et al (2022) alarms about a low percentage of patients, accounting for 17.8% who are physically active and ∼60% of patients who do not even achieve the minimum recommended time of physical activity. One of the barriers that discourage patients to perform activities includes fear of hypoglycemia, lack of time, motivation, and knowledge about dealing with diabetes on exertion Montt-Blanchard et al (2022).…”

“…At the same time, the study performed by Montt-Blanchard et al (2022) alarms about a low percentage of patients, accounting for 17.8% who are physically active and ∼60% of patients who do not even achieve the minimum recommended time of physical activity. One of the barriers that discourage patients to perform activities includes fear of hypoglycemia, lack of time, motivation, and knowledge about dealing with diabetes on exertion Montt-Blanchard et al (2022). This proves that appropriate education is extremely important in the process of diabetes management and should be a part of treatment from an early time of the onset of the disease, which unfortunately depends on center readiness and the competences of medical staff (Dash et al, 2020).…”

“…If a person would be appropriately acquainted with procedures that should be followed by hypoglycemia, they might be more confident and be willing to undertake physical activity more often. It is also presented that through performing physical exertion, people suffering from diabetes create their own strategies, which aim for maintaining blood glucose levels within range, based on the experience and the data obtained during past workouts (Montt-Blanchard et al, 2022 ). It could be compared with a closed loop as people develop strategies that result in appropriate blood glucose management during exertion, they become more motivated to exercise in the future.…”

“…Therefore, physical activity contributes to improving resilience, which is extremely important in everyday life functioning when suffering from type 1 diabetes. The statement of one of the participants of the study “diabetes started bleeding into my identity through running (…) [diabetes] is making me utilize my creativity as a primary self-identifier” suggests that, for some people, running becomes a means of coping with diabetes and helps in the acceptance of the disease (Montt-Blanchard et al, 2022 , p. 7). It can also play a role in shaping a patient's character and motivation, which is reflected in improved wellbeing and mental health.…”

Individualized visual narratives: type 1 diabetes management strategies among three runners in the London Marathon

“…Through analytic autoethnography (Montt-Blanchard et al, 2022), this report presents the marathon experiences of three T1D runners. The objective is to highlight challenges faced by high-level athletes with T1D and offer insights for healthcare professionals to optimize patient care and support endurance pursuits.…”