Examining the Cognitive, Practical, and Emotional Demands of Managing Physical Activity in Adolescents With Type 1 Diabetes: A Qualitative Study With Adolescents, Parents, and Healthcare Professionals

Objective: Adolescents with type 1 diabetes (T1D) face unique barriers to physical activity (PA), and most do not meet recommended targets despite its recognised health benefits. To address the lack of tailored, evidence-based support for this group, this study explores how adolescents manage PA and how it is influenced by the wider support system, including parents, carers, and healthcare professionals (HCPs). 

Research Design and Methods: Semi-structured interviews were conducted with adolescents with T1D (n = 11), parents/carers (n = 15), and HCPs (n = 11). Adolescents were aged between 12 and 18 (64% female). HCPs were dieticians (n = 7), nurses (n = 2), a doctor (n = 1) and a health and wellbeing practitioner (n = 1). Interviews explored practical, emotional, and contextual factors influencing PA. Data were analysed using thematic analysis. 

Results: Participants described cognitive, emotional, and practical demands of managing T1D during PA. Thematic analysis identified three overarching themes: (1) the mental effort required to manage diabetes with PA, including parental anxiety, desire for normality, and unpredictability of glucose responses; (2) practical and organisational challenges, such as access to supportive environments, technology, and activity-specific logistics; and (3) adaptive management strategies, including trial and error, parental involvement, peer learning, and variable clinical support. Current support was often generic, leading families to rely on self-devised strategies and informal networks to support their individual needs. 

Conclusion: Enhanced, youth-friendly, and activity-specific guidance is needed for adolescents with T1D. This should include training for healthcare professionals, teachers, and coaches. Future work should prioritise the co-design of resources and interventions with young people and families, integrating structured peer support.