This case study describes a 40-year-old lady with long-standing type 1 diabetes for 37 years. Despite a history of recurrent
hypoglycemia, impaired hypoglycemia awareness and an eating disorder, by changing to continuous subcutaneous insulin
infusion therapy with an insulin pump, in combination with carbohydrate counting, she restored her hypoglycemia awareness
and reduced blood glucose variability. This gave her the confidence to register to run in a marathon but during training
experienced wide fluctuations in blood glucose with frequent hypoglycemia. With continuous glucose monitoring using a
glucose sensor, she was able to undertake a strenuous training programme and subsequently manage her glucose to avoid
hypoglycemia and maintain good control for the duration of the marathon. For some people with type 1 diabetes,
technological advances have provided the capacity to reduce hypoglycemia risk, improve their quality of life, and enable them
to participate in demanding physical activities.