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Professional cycling is one of the most physically demanding endurance sports. While literature exists on the needs of people with diabetes during exercise and sport of low to medium levels of intensity, there is less information around specific needs during endurance sports, and little published information on professional endurance sports. The approach to diabetes management taken by a professional cycling team comprised solely of people with type 1 diabetes provides useful insight for health care professionals with patients wanting to take up competitive sport or exercise at more intense levels. A systematic approach to achieving tight glycaemic control is taken that includes monitoring and analysis of blood glucose levels before, during and after training and competition, and a structured and balanced nutrition and race management plan. With support from experienced health care professionals, intense physical activity and endurance sports can be an option for individuals with diabetes, as long as they are educated about their condition and disciplined and committed to achieving glycaemic control. Copyright © 2013 John Wiley & Sons.