In recent years, TNN has placed a strong focus on research to build insight into how athletes can compete at a professional level while managing their diabetes. TNN is supported by a multidisciplinary team of doctors, coaches, researchers, and nutritionists who aim to help the athletes contend in these ultra- endurance events while managing glycaemia. Team Novo Nordisk (TNN) is the world's first all-diabetes pro cycling team comprised exclusively of athletes living with T1D, who compete in elite-level cycle stage races. Developing strategies to navigate these challenges is achievable with careful planning and determination. Competing in endurance sports as an individual living with type 1 diabetes (T1D) is particularly challenging because the glucoregulatory response to exercise is impaired, mainly because they do not secrete physiological amounts of endogenous insulin. 4 Professional riders must regularly compete alongside multiple uncontrollable variables, including changing weather and road conditions as well as different altitudes. 1- 3 Road cycling involves high training volume, long seasons with frequent competition days, races up to 300 km (180 miles), and stage races lasting between five days to three weeks. Riders must regularly push themselves to their physical limits, enduring extreme stresses to their cardiovascular and muscular systems. Professional cycling is a demanding sport. In recent years, TNN has placed a high level of emphasis on research to improve safety and athletic performance while also striving to make these insights widely available to benefit the broader community. This article highlights the current learnings and data-informed strategies being employed to assist management of diabetes in a professional endurance sport environment, almost 10 years after the publication of ‘Lessons from the professionals: diabetes and pro cycling’ (2013). Advances in technologies, such as continuous glucose monitoring, have facilitated non-invasive and comprehensive observation of the TNN riders, who are supported by a multidisciplinary team of doctors, coaches, researchers, and nutritionists to formulate individualised data-driven strategies. TNN has developed, refined, and adapted evidence-based scientific strategies for managing nutrition and glycaemia in elite-level athletes with T1D participating in ultra-endurance events. Despite the challenges, Team Novo Nordisk (TNN) has demonstrated that with planning and determination, people with T1D can successfully pursue endurance sports. However, the effects of exercise on glucose concentration are complex, and despite advances in supportive technologies and insulins, exercise remains a challenge for people living with T1D. People living with type 1 diabetes (T1D) are recommended to undertake regular exercise to maintain health and wellbeing.
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