Physical workload and glycemia changes during football matches in adolescents with type 1 diabetes can be comparable

A Comprehensive Review of Continuous Glucose Monitoring Accuracy during Exercise Periods

Continuous Glucose Monitoring (CGM) has been a springboard of new diabetes management technologies such as integrated sensor-pump systems, the artificial pancreas, and more recently, smart pens. It also allows patients to make better informed decisions compared to a few measurements per day from a glucometer. However, CGM accuracy is reportedly affected during exercise periods, which can impact the effectiveness of CGM-based treatments. In this review, several studies that used CGM during exercise periods are scrutinized. An extensive literature review of clinical trials including exercise and CGM in type 1 diabetes was conducted. The gathered data were critically analysed, especially the Mean Absolute Relative Difference (MARD), as the main metric of glucose accuracy. Most papers did not provide accuracy metrics that differentiated between exercise and rest (non-exercise) periods, which hindered comparative data analysis. Nevertheless, the statistic results confirmed that CGM during exercise periods is less accurate.

Exercise and sport - challenges and benefits for the children and adolescents with type 1 diabetes

"Regular physical activity is able to replace almost every drug, but all drugs taken together will not replace exercise" This statement was written in XVI century by Wojciech Oczko (1537-1599) royal doctor of Polish Kings. Despite medical advances over 500 years, this sentence is still relevant today. In the hundred years since the discovery of insulin, enormous progress has also been made in the pharmacological treatment of type 1 diabetes mellitus (T1DM). In the last decades new formulations of insulin, new methods of insulin delivery, e.g., advanced closed-loop hybrid systems have significantly improved glucose control. However, we must remember that good glycemic control is a key, but not one factor in preventing the development of chronic diabetes complications. Regular physical activity is associated with greater insulin sensitivity, increased  fitness,  better lipid profile and blood pressure [1]. It extends remission duration in children with new onset diabetes mellitus [2]. It significantly decreases risk of premature cardiovascular morbidity and all-cause mortality. Regular physical activity has not only health but also social benefits for children and adolescents with diabetes mellitus, so it is one of the fundamental parts of diabetes management and should be encouraged [3].