Competitive Sports Participation and Its Association with Glycemic Control and Disordered Eating Behaviors in Individuals with Type 1 Diabetes Running: Competitive Sports, Glycemic Control T1D

PURPOSE: Adolescents with Type 1 Diabetes (T1D) often face unique challenges in maintaining glycemic control, with a higher risk of disordered eating behaviors (DEB). While physical activity may be associated with improved metabolic outcomes, its relationship with DEB in adolescents with T1D remains unclear. This study aimed to evaluate the clinical characteristics and prevalence of DEB among adolescents and young adults with T1D who participate in competitive sports compared to their non-athlete peers. METHODS: An observational, cross-sectional study of 245 individuals with T1D, 13 to 21 years of age. All adolescents and young adults with T1D receiving care at our clinic, including those in competitive sports who were additionally followed by the Pediatric Diabetes Sports Clinic, were eligible for inclusion. Data were collected from medical charts, personal technological devices for assessment of glycemic variability, and self-reported questionnaires, including assessments of DEB. RESULTS: From all participants, 12.2% were engaged in competitive sports. Participation in competitive sports was associated with lower HbA1c (OR: 0.44, 95% CI: 0.24-0.80, P = 0.007), lower DEB (OR: 0.17, 95% CI: 0.04-0.67, P = 0.012), higher BMI-Z score (OR: 1.70, 95% CI: 1.02-2.83, P = 0.04), and higher socioeconomic position (OR: 1.33, 95% CI: 1.05-1.69, P = 0.015). Participants who engaged in competitive sports were more likely to use hybrid closed-loop (HCL) systems compared to those who did not (36.6% vs. 17.6%, respectively, P = 0.026). CONCLUSIONS: Competitive sports participation in adolescents and young adults with T1D is associated with improved glycemic control and a lower prevalence of DEB. These findings highlight the potential benefits of encouraging structured physical activity as part of comprehensive diabetes care.