601-P: Exploring Strategies to Manage Hyperglycemia-Related Anxiety during Competition in Elite Athletes with Type 1 Diabetes—A Qualitative Analysis
Authors: KATZ ALEXANDRA , SHULKIN AIDAN , FORTIER MARC-ANDRE , HOUSNI ASMAA , TALBO MERYEM K. , SESBRENO ERIK , YARDLEY JANE E. , KICHLER JESSICA C. , RABASA-LHORET RÉMI , BRAZEAU ANNE-SOPHIE 
Published: June 2024

Introduction & Objective: Elite athletes with type 1 diabetes (T1D) face unique challenges managing their blood glucose levels, as competitions can cause unpredictable fluctuations. The impact of hyperglycemia-related anxiety on their performance and diabetes management is important, yet research is limited. This study explores strategies used to prevent hyperglycemia-related anxiety during competition and highlights additional approaches they can use.
Methods: Elite athletes &gt;18 years old with T1D who self-reported hyperglycemia-related anxiety during competitions were recruited to participate in virtual semi-structured interviews. A discussion guide was used to direct the 30-60 minute conversation using open-ended questions. Interview content was analysed using an Interpretative Phenomenological Analysis approach.
Results: Ten elite athletes with T1D (average age: 25 ± 3 years; duration of TID: 12 ± 8 years; # of competitions per year: 27 ± 19; training time per week: 12 ± 6 hours) reported the strategies they currently use during competition to manage hyperglycemia-related anxiety. These include: carefully managing insulin and nutrition intake, leveraging technology, practicing relaxation techniques, establishing routines and maintaining adequate sleep hygiene.
Additional approaches that could be implemented include: addressing the psychological burden, ensuring support teams have sufficient tools and resources, promoting self-awareness and establishing peer mentorship networks.
Conclusion: Elite athletes with T1D use physiological and psychological interventions to mitigate hyperglycemia-related anxiety during competition, emphasising the need for further support and education. Targeted strategies and individualized approaches are necessary to optimize performance and well-being in this population.

Disclosure
A. Katz: None. A. Shulkin: None. M. Fortier: None. A. Housni: None. M.K. Talbo: None. E. Sesbreno: None. J.E. Yardley: Speaker's Bureau; Dexcom, Inc. Research Support; LifeScan Diabetes Institute. J.C. Kichler: None. R. Rabasa-Lhoret: Other Relationship; Abbott, AstraZeneca, Bayer Inc., Boehringer-Ingelheim, Dexcom, Inc. Research Support; Diabetes Canada. Other Relationship; Eli Lilly and Company. Research Support; Cystic Fibrosis Canada, Canadian Institutes of Health Research, FFRD - Fondation Francophone pour la Recherche du Diabète. Other Relationship; Janssen Pharmaceuticals, Inc. Research Support; Juvenile Diabetes Research Foundation (JDRF). Other Relationship; Novo Nordisk, GlaxoSmithKline plc. Consultant; HLS Therapeutics Inc., Insulet Corporation. Speaker's Bureau; CPD Networks. Other Relationship; Medtronic. Consultant; Pfizer Inc. Speaker's Bureau; Tandem Diabetes Care, Inc. Other Relationship; Sanofi. Speaker's Bureau; Vertex Pharmaceuticals Incorporated. Research Support; SFD - Société Francophone du Diabète. A. Brazeau: Other Relationship; Dexcom, Inc. Research Support; Canadian Institutes of Health Research, Juvenile Diabetes Research Foundation (JDRF), Diabète québec, Fonds de recherche du Québec en Santé.

Funding
Chaire J.A DeSFve