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

Nutrients. 2016 Aug 10;8(8):489. doi: 10.3390/nu8080489.

Abstract

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 (LTP₁), and 5% below the second lactate turn point (LTP₂) (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.

Keywords: blood glucose; continuous glucose monitoring; diabetes; exercise.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Bicycling
  • Blood Glucose / analysis*
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / diet therapy
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / therapy*
  • Diet, Diabetic
  • Dietary Carbohydrates / administration & dosage
  • Dietary Carbohydrates / adverse effects
  • Drug Monitoring
  • Drug Therapy, Combination
  • Glycated Hemoglobin / analysis
  • High-Intensity Interval Training / adverse effects*
  • Humans
  • Hyperglycemia / diagnosis
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / diagnosis
  • Hypoglycemia / prevention & control*
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use
  • Insulin, Long-Acting / therapeutic use
  • Insulin, Short-Acting / administration & dosage
  • Insulin, Short-Acting / therapeutic use
  • Lactic Acid / blood
  • Male
  • Monitoring, Ambulatory*
  • Reproducibility of Results
  • Young Adult

Substances

  • Blood Glucose
  • Dietary Carbohydrates
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin, Long-Acting
  • Insulin, Short-Acting
  • hemoglobin A1c protein, human
  • Lactic Acid
  • insulin degludec