Do new technologies for people with type 1 diabetes reduce obstacles to physical activity?

Physical activity is known to provide many benefits to people who live with type 1 diabetes (T1D) such as improved blood sugar levels, cardiovascular health, well-being and quality of life. Still, many people with T1D find it challenging to do it regularly due to diabetes-specific barriers and diabetes’s impact on daily life.  

In 2008, a study revealed that fear of hypoglycemia was the main barrier to physical activity for people with T1D. 

Technology has taken giant steps since then, with the introduction of tools such as continuous glucose monitors (CGMs), insulin pumps and automated insulin delivery systems (also called “artificial pancreases”), which have completely transformed diabetes management through a reduced risk of hypoglycemia and improved quality of life.

Do these tech innovations help reduce barriers to physical activity for people with T1D? Is fear of hypoglycemia still a major hurdle? Do some people face more challenges than others? 

We have looked into BETTER registry data to find answers to these questions! 

Fear of hypoglycemia remains the main obstacle 

In a sample of 1,117 BETTER registry participants aged 14 and over, the data showed that close to half of participants identified fear of hypoglycemia as a main obstacle to physical activity. Other obstacles identified include weather conditions and work schedule. Unsurprisingly, the more barriers a person identified, the less physically active they were. 

New technology doesn’t eliminate obstacles (yet) 

One could assume that tech innovations in diabetes management would eliminate obstacles to physical activity; however, people who use a CGM, an insulin pump or an artificial pancreas, on the contrary, cite fear of hypoglycemia and fear of disrupted blood sugar and insulin management as obstacles in greater numbers than people who don’t use these technologies. Undoubtedly, monitoring blood sugar fluctuations in real time during physical activity is important and helpful, but it doesn’t solve all the problems. In some cases, it even exacerbates them.

Who faces the most hurdles?

Our analyses revealed that certain situations or characteristics can make a person more likely to have difficulty with physical activity.

The following were highlighted: 

• Being a female;
• Having a low income and education level;
• Being overweight or obese;
• Taking antidepressants;
• Having a recent diagnostic;
• Having more difficulty managing blood sugar levels;
• Having gone through severe hypoglycemia recently;
• Lacking confidence in one’s ability to manage hypoglycemia; 

Factors directly associated with the challenges of daily diabetes management such as a recent episode of severe hypoglycemia are mostly expected. Other factors reflect life situations, for instance, having limited financial means. Women with T1D identified obstacles to physical activity in greater numbers, which confirms observations made in other studies based on BETTER registry data. This is a good reminder to take a person’s sex into account when encouraging someone to start, resume or keep up physical activity.

And now? 

This study gave us a better understanding of obstacles to physical activity for people with T1D today. Despite tech innovations, diabetes-specific obstacles such as fear of hypoglycemia or fear of disrupted blood sugar management remain very present, as well as general obstacles such as bad weather conditions, restricting work schedule, or the absence of sports facilities. The study also found that some people are more likely to experience these challenges.  

Next, we will seek to identify concrete solutions to reduce these barriers. The end goal is clear: to encourage and support people with T1D and help them do their preferred physical activities and live as normal a life as possible for the benefit of their physical … and mental health!  

References :

• Guédet, C et al. “Exploring perceived barriers to physical activity among individuals with type 1 diabetes in the era of new technologies: An analysis from the BETTER registry.” Diabetes & metabolism vol. 51,5 (2025): 101677. doi:10.1016/j.diabet.2025.101677
• Prévost, Melinda S et al. “Gender Differences in Strategies to Prevent Physical Activity-Related Hypoglycemia in Patients With Type 1 Diabetes: A BETTER Study.” Diabetes care vol. 45,3 (2022): e51-e53. doi:10.2337/dc21-1899
• Talbo, Meryem K et al. “Gender differences in reported frequency and consequences of hypoglycemia among adults living with type 1 diabetes: Results from the BETTER registry.” Diabetes research and clinical practice vol. 202 (2023): 110822. doi:10.1016/j.diabres.2023.110822