Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems
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POSITION STATEMENT
Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA) Othmar Moser 1,2 & Michael C. Riddell 3 & Max L. Eckstein 1 & Peter Adolfsson 4,5 & Rémi Rabasa-Lhoret 6,7,8,9 & Louisa van den Boom 10 & Pieter Gillard 11 & Kirsten Nørgaard 12 & Nick S. Oliver 13 & Dessi P. Zaharieva 14 & Tadej Battelino 15,16 & Carine de Beaufort 17,18 & Richard M. Bergenstal 19 & Bruce Buckingham 14 & Eda Cengiz 20,21 & Asma Deeb 22 & Tim Heise 23 & Simon Heller 24,25 & Aaron J. Kowalski 26 & Lalantha Leelarathna 27,28 & Chantal Mathieu 11 & Christoph Stettler 29 & Martin Tauschmann 30 & Hood Thabit 27 & Emma G. Wilmot 31,32 & Harald Sourij 1 & Carmel E. Smart 33,34 & Peter G. Jacobs 35 & Richard M. Bracken 36 & Julia K. Mader 1
# Jointly held by John Wiley & Sons, and Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Physical exercise is an important component in the management of type 1 diabetes across the lifespan. Yet, acute exercise increases the risk of dysglycaemia, and the direction of glycaemic excursions depends, to some extent, on the intensity and duration of the type of exercise. Understandably, fear of hypoglycaemia is one of the strongest barriers to incorporating exercise into daily life. Risk of hypoglycaemia during and after exercise can be lowered when insulin-dose adjustments are made and/or additional carbohydrates are consumed. Glycaemic management during exercise has been made easier with continuous glucose monitoring (CGM) and intermittently scanned continuous glucose monitoring (isCGM) systems; however, because of the complexity of CGM and isCGM systems, both individuals with type 1 diabetes and their healthcare professionals may struggle with the interpretation of given information to maximise the technological potential for effective use around exercise (i.e. before, during and after). This position statement highlights the recent advancements in CGM and isCGM technology, with a focus on the evidence base for their efficacy to sense glucose around exercise and adaptations in the use of these emerging tools, and updates the guidance for exercise in adults, children and adolescents with type 1 diabetes. Keywords Adolescents . Adults . CGM . Children . Continuous glucose monitoring . Exercise . Physical activity . Position statement . Type 1 diabetes This article is co-published in the journals Diabetologia and Pediatric Diabetes, available at https://doi.org/10.1007/s00125-020-05263-9 and https://onlinelibrary.wiley.com/journal/13995448, respectively. This is an abridged version of the Position Statement. The full-length version is available on the EASD website. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00125-02
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