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Diabetes News: Exercise and CGMs [1]

['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.']

Date: 2025-04-02

It is not news in itself that exercise uses up sugar as fuel, often reducing blood glucose levels. But it is news that research is quantifying the effects, and that individuals have the tools to do so for themselves, to reduce elevated glucose levels to some extent without insulin injections, and with due care not to produce hypoglycemia. This can be done with some inconvenience using finger sticks, but with much greater convenience using a CGM and a phone app.

This method is not to be used for dangerously high glucose readings, where it takes too long.

Researchers are studying the use of CGMs for patients with both Type 1 and Type 2 diabetes.

Continuous Glucose Monitoring and Exercise in Type 1 Diabetes: Past, Present and Future

Prior to the widespread use of continuous glucose monitoring (CGM), knowledge of the effects of exercise in type 1 diabetes (T1D) was limited to the exercise period, with few studies having the budget or capacity to monitor participants overnight. Recently, CGM has become a staple of many exercise studies, allowing researchers to observe the otherwise elusive late post-exercise period. We performed a strategic search using PubMed and Academic Search Complete. Studies were included if they involved adults with T1D performing exercise or physical activity, had a sample size greater than 5, and involved the use of CGM. Upon completion of the search protocol, 26 articles were reviewed for inclusion. While outcomes have been variable, CGM use in exercise studies has allowed the assessment of post-exercise (especially nocturnal) trends for different exercise modalities in individuals with T1D. Sensor accuracy is currently considered adequate for exercise, which has been crucial to developing closed-loop and artificial pancreas systems. Until these systems are perfected, CGM continues to provide information about late post-exercise responses, to assist T1D patients in managing their glucose, and to be useful as a tool for teaching individuals with T1D about exercise. 2,3, Researchers now know that aerobic activities of various intensities and durations lead to declines in blood glucose and a high risk of hypoglycemia [ 1 4 ]—unless these activities are performed in a fasting state first thing in the morning, where increases in blood glucose have been observed [ 5 6 ]. A similar trend has been found for resistance exercise, where studies performed in the afternoon observed declines in blood glucose [ 7 8 ], while those performed in the morning were associated with either an increase [ 9 10 ], or no effect [ 11 ] on blood glucose concentration. Studies have also shown that high intensity (anaerobic) activities have the opposite effect on blood glucose to aerobic activities.

It is extremely important for diabetes sufferers who want to try such a method to create individualized data for themselves on their responses to food, insulin and other medications, and exercise of various types at different times of day, which differ for everybody depending on the type and details of their diabetes, their weight, body types, ages, and health apart from diabetes.

I have written here about the spreadsheet I made a while back on my responses to measured doses of glucose and most of the foods I commonly eat. For me, that’s a vegetarian low-carb ketogenic diet. Your mileage will definitely vary.

I have been ramping up my own exercise program, including exercises specifically to counter neuropathy in my feet and fingers. I am nowhere near the recommended times of 150 minutes per week, since I started in a period of serious weakness, which is only slowly improving. I will make more spreadsheets as I go along, and try to add more kinds of exercise. No running or jogging yet, but a bit of stair climbing, stretches, and strength training.

Accuracy of Continuous Glucose Monitoring (CGM) during Continuous and High-Intensity Interval Exercise in Patients with Type 1 Diabetes Mellitus

Continuous exercise (CON) and high-intensity interval exercise (HIIE) can be safely performed with type 1 diabetes mellitus (T1DM). Additionally, continuous glucose monitoring (CGM) systems may serve as a tool to reduce the risk of exercise-induced hypoglycemia. It is unclear if CGM is accurate during CON and HIIE at different mean workloads. Seven T1DM patients performed CON and HIIE at 5% below (L) and above (M) the first lactate turn point (LTP 1 ), and 5% below the second lactate turn point (LTP 2 ) (H) on a cycle ergometer. Glucose was measured via CGM and in capillary blood (BG). Differences were found in comparison of CGM vs. BG in three out of the six tests ( p < 0.05). In CON, bias and levels of agreement for L, M, and H were found at: 0.85 (−3.44, 5.15) mmol·L−1, −0.45 (−3.95, 3.05) mmol·L−1, −0.31 (−8.83, 8.20) mmol·L−1 and at 1.17 (−2.06, 4.40) mmol·L−1, 0.11 (−5.79, 6.01) mmol·L−1, 1.48 (−2.60, 5.57) mmol·L−1 in HIIE for the same intensities. Clinically-acceptable results (except for CON H) were found. CGM estimated BG to be clinically acceptable, except for CON H. Additionally, using CGM may increase avoidance of exercise-induced hypoglycemia, but usual BG control should be performed during intense exercise.

Continuous Glucose Monitoring and Physical Activity

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