
Exercise and Glucose Metabolism in Persons with Diabetes Mellitus: Perspectives on the Role for Continuous Glucose Monitoring
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Continuous Glucose Monitoring Technology
Given the problems of exercise-associated disturbances in glycemia described earlier and the risk for hypoglycemia unawareness, frequent monitoring of glucose is essential for active individuals with type 1 diabetes. Most exercise-related guidelines recommend self-monitoring of blood glucose (SMBG) with capillary blood at least twice before exercise and every 30 min during the exercise as well as hours into recovery.2 This recommendation for frequent SMBG is difficult to adhere to for some, because it requires a pause in activity, a limitation that would be ameliorated with CGM. Moreover, a fear of exercise associated hypoglycemia is a major barrier to exercise participation in adults5 and in youth,6 and CGM might help increase self-efficacy during sport. Finally, CGM has the potential to assist active persons with diabetes by recording exercise-associated changes in blood glucose levels, and this information may be useful in developing appropriate insulin and carbohydrate modifications during times of increased activity. A brief overview of CGM technology is provided in the next section.
Continuous glucose monitoring devices have been available since the late 1990s and were developed for the measurement of interstitial glucose levels in subcutaneous tissue as a reflection of circulating glucose concentrations. The main components of CGM include a transcutaneous sensor inserted into the abdomen or arm, a transmitter, and a receiver that is typically worn on a belt or carried in a pocket. With this technology, the implanted sen
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