JMIR Publications

ABSTRACT

Background:

Diabetes technologies such as CGMs, insulin pumps, and closed-loop systems have transformed self-management practices. In ultra-endurance contexts, these tools offer refined glycemic control but introduce new logistical, cognitive, and social constraints.

Objective:

To explore the technological experiences of individuals with type 1 diabetes engaged in ultra-endurance sports, focusing on tensions between autonomy, mental load, and material vulnerability.

Methods:

A qualitative study was conducted using semi-structured interviews with 13 participants. Transcripts were analyzed through inductive thematic analysis, with double coding and triangulation. Five major themes were identified. Patient partners were involved throughout the research process, including the co-construction of the research question, feedback on interim findings, and review of the final manuscript. Methodological rigor was ensured using the COREQ checklist.

Results:

Five key dimensions emerged: technological evolution, perceived benefits, mental load, management of the unexpected, and social visibility. Participants described a tension between the promise of autonomy and the realities of technological dependence, vigilance, and fragility.

Conclusions:

This study highlights the ambivalences of connected care in extreme sports contexts. It offers a critical perspective on bio-tracking and invites reflection on robust, situated, and sustainable autonomy in digital health. Clinical Trial: Not applicable – This is a qualitative study and does not involve a clinical trial requiring registration.