Continuous glucose monitoring system during physical exercise in adolescents with type 1 diabetes

Abstract

We demonstrate that, even during days that included episodic strenuous physical exercise, CGMS could provide useful information on glucose fluctuations during day and night, albeit with significant failure rates.

Accuracy of Continuous Glucose Monitoring During Exercise in Type 1 Diabetes Pregnancy

“…Similar results have been reported in children (median RAD, 17%), adolescents (mean RAD, 23%), and nonpregnant adults (mean RAD, 22%) with T1D testing glucose oxidase-based sensors during exercise. 10,12,25 In contrast, a recent study in 12 adults found better accuracy of the CGM during both resistance and aerobic exercise compared with resting conditions. In our study, 13% of values during exercise were considered clinically unsafe using the Clarke error grid analysis with the potential to lead to wrong treatment decisions, compared with only 4% when sedentary.…”

“…In a study of 58 adolescents during three sports camps, one-third of sensors (CGMS System Gold) required replacing within 48 h because of disconnection from sweating or loss of signal. 12 Accuracy was lower for high-contact activities, as observed by mean RAD of 19%, 24%, and 27% for the golf, soccer, and floorball and/or cross-country skiing camps, respectively. In our study there were no problems with loss of signal during exercise, with sensors remaining in situ for the duration of the visit in all participants, although the intensity of exercise performed may not have been high enough to result in displacement.…”

“…8 Another potential source of inaccuracy is sensor dislodgement due to sweating or by direct mechanical forces on sensors sited in exercising limbs. [11][12][13] The noninvasive GlucoWatch Ò Biographer (Cygnus, Redwood City, CA), no longer available for clinical use, measures interstitial glucose using reverse iontophoresis. It was the first CGM device to be tested during exercise, demonstrating a progressive decline in accuracy with more intense activity and a high skip rate due to perspiration.…”

“…Accuracy, as measured by the median relative absolute difference (RAD) between paired sensor and reference glucose values in time, ranges from 11% to 14% under resting conditions. 8,9 There is limited objective evidence on performance of CGMs during physical activity, [10][11][12][13][14][15] in particular none using current-generation sensors. There are no studies evaluating CGM use in pregnant women during exercise.…”

In-Vitro Performance of the Enlite Sensor in Various Glucose Concentrations during Hypobaric and Hyperbaric Conditions

“…7 An individual with diabetes travels as frequently as everybody else, and physical activity is also advocated in all age groups. 1,8 Continuous glucose monitoring is a technique used to detect 9 and decrease the risk of hypoglycemia 10 during physical activity and has also been shown to enable assessment of glucose levels before, during, and after underwater diving. [11][12][13] When engaging in activities at high altitudes, there is also a need to monitor glucose levels.…”