PE teachers, sports coaches, and other physical activity providers can play an important role in helping children and adolescents with type 1 diabetes to be active. This study explored their experiences of providing support, the challenges they face, and what would help them feel more confident and better equipped.

Why this study was done

Many young people with type 1 diabetes are less active than recommended, and support from schools and sports settings can make a real difference to participation. However, previous research has shown that families and young people often have low confidence in the support available from teachers and coaches, and little was known about the experiences of physical activity providers themselves.

This study was carried out to understand the current context in which PE teachers, sports coaches, and other providers are working, and to identify practical ways to improve support in physical activity settings.

How the study was carried out

We used a mixed-methods design combining an online survey and semi-structured interviews. The survey included 34 physical activity providers from across the UK, and follow-up interviews were carried out with nine participants to explore experiences in more depth.

Participants included PE teachers, sports coaches, and outdoor activity supervisors who supported adolescents aged 12 to 18 years. Survey data were analysed descriptively, and interview data were examined using thematic analysis.

What we found

The study found clear gaps in training, knowledge, and confidence. Only half of respondents felt confident supporting an adolescent with type 1 diabetes to take part in physical activity, fewer than one-third had received any T1D-related training, and only around a quarter felt confident dealing with a diabetes-related emergency during activity.

Awareness of formal policy was also low. Only four respondents, around 11%, said they were aware of a school or club policy for supporting children and adolescents with type 1 diabetes, which was notably lower than awareness of policies for other chronic conditions such as asthma, epilepsy, or allergies.

Interviews showed that support was often reactive rather than proactive. In the absence of formal training or clear guidance, providers relied on parents, young people themselves, school nurses, clinical teams, or colleagues with personal experience of diabetes to learn what to do. Participants also described using practical strategies such as regular communication, checking in during sessions, ensuring quick access to hypo treatments, and making use of diabetes technology such as continuous glucose monitors.

At the same time, providers emphasised that support needs vary from one young person to another. This made it difficult to rely on generic assumptions, and many participants highlighted the importance of individualised communication and trust.

Why it matters

These findings show that physical activity providers are often willing to help, but many are doing so without enough training, guidance, or organisational support. As a result, support may depend too heavily on individual initiative, personal experience, or the young person and family taking responsibility themselves.

For the wider ISPA-T1D programme, this study highlights the need for targeted training for teachers and coaches, clearer school and club policies, and practical resources that support safe, inclusive participation in physical activity for young people with type 1 diabetes.