Monitoring exercise-induced changes in glycemic control in type 2 diabetes

• Published in: Medicine and science in sports and exercise Vol. 38; no. 2; pp. 201 - 207
• Main Authors: MACDONALD, Adam L, PHILP, Andrew, HARRISON, Moira, BONE, Adrian J, WATT, Peter W
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-02-2006
• Subjects: Analysis of Variance; Biological and medical sciences; Blood Glucose - analysis; Case-Control Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - therapy; Exercise Therapy - methods; Female; Fundamental and applied biological sciences. Psychology; Glucose Tolerance Test; Humans; Male; Middle Aged; Monitoring, Ambulatory - instrumentation; Space life sciences; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports; Endocrinopathy; Type 2 diabetes; Physical exercise; Human; Sport; GLUCOSE CONTROL; Metabolic diseases; Insulin resistance; Glucose; PHYSICAL ACTIVITY; Monitoring
• ISSN: 0195-9131; 1530-0315
• DOI: 10.1249/01.mss.0000183852.31164.5a

The present study determined the efficacy of the Continuous Glucose Monitoring System (CGMS) during moderate exercise and monitored the changes in whole-day glucose profiles using the CGMS in individuals with and without type 2 diabetes.
Six, obese, diet-treated individuals with and four age-matched individuals without type 2 diabetes were monitored using the CGMS for 3 d. Subjects cycled at 90% of a predetermined lactate threshold for 1 h at approximately 09:00 h on day 2, during which venous blood was sampled at 10-min intervals and immediately analyzed for glucose concentrations.
Venous blood glucose and CGMS values declined during exercise in the diabetes (P < 0.001) but not the control group (P = 0.085). The CGMS overestimated blood glucose in the control (P = 0.003) and the diabetes (P = 0.045) groups during exercise. The number of data points outside of the 95% confidence intervals was <5% in both groups, showing that there is a statistically acceptable level of agreement between venous blood glucose and CGMS values during exercise. Moderate exercise improved whole-day average glucose concentrations (P = 0.007) and whole-day area under the glucose curve (P = 0.016) values (AUCglu), and the time spent within +/-10% of fasting venous glucose (FVG) increased in the diabetes group (P = 0.021). No such effects were seen in the control group.
Using continuous glucose monitoring we were able to demonstrate that a period of moderate exercise improved whole-day glycemic control in obese individuals with type 2 diabetes. The CGMS should only be used as an adjunct and not as an alternative to frequent blood glucose sampling when examining the changes in glucose values during exercise in individuals with and without type 2 diabetes.