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)

• DOI: 10.1007/s00125-020-05263-9
• Publication Date: 2020-10-12T23:02:51Z
• Authors: Othmar Moser; Michael C. Riddell; Max L. Eckstein; Peter Adolfsson; Rémi Rabasa-Lhoret; Louisa van den Boom; Pieter Gillard; Kirsten Nørgaard; Nick S. Oliver; Dessi P. Zaharieva; Tadej Battelino; Carine de Beaufort; Richard M. Bergen...; Bruce Buckingham; Eda Cengiz; Asma Deeb; Tim Heise; Simon Heller; Aaron J. Kowalski; Lalantha Leelarathna; Chantal Mathieu; Christoph Stettler; Martin Tauschmann; Hood Thabit; Emma G. Wilmot; Harald Sourij; Carmel E. Smart; Peter G. Jacobs; Richard M. Bracken; Julia K. Mader
• Keywords: Adult; Blood Glucose; Adolescent; type 1 diabetes; Sustainable Development Goals; Diabetes Mellitus, Type 1/drug therapy; 610; physical activity; 610 Medicine & health; Position statement; Glycemic Control; Adolescents; 796; 03 medical and health sciences; 0302 clinical medicine; children; Exercise/physiology; adults; Adults; Humans; Hypoglycemic Agents; Insulin; adolescents; Child; Children; Continuous glucose monitoring; Exercise; Quality Of Life; SDG 3; Blood Glucose/metabolism; exercise; CGM; Physical activity; Blood Glucose Self-Monitoring; position statement; Diabetes Mellitus, Type 1/physiopathology; Hypoglycemic Agents/administration & dosage; 3. Good health; Type 1 diabetes; Diabetes Mellitus, Type 1; quality of life; Ispad Guidelines; Quality of Life; continuous glucose monitoring; Glycemic Control/methods; Insulin/administration & dosage

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 (ie, 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.