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. 2023 Apr 30;12(9):3237.
doi: 10.3390/jcm12093237.

Using Continuous Glucose Monitoring to Prescribe a Time to Exercise for Individuals with Type 2 Diabetes

Courtney R Chang  1   2 , Brooke M Russell  1   2 , Tannia Cyriac  1   2 , Monique E Francois  1   2
Affiliations

Using Continuous Glucose Monitoring to Prescribe a Time to Exercise for Individuals with Type 2 Diabetes

Courtney R Chang et al. J Clin Med. .

Abstract

This study examines the potential utility of using continuous glucose monitoring (CGM) to prescribe an exercise time to target peak hyperglycaemia in people with type 2 diabetes (T2D). The main aim is to test the feasibility of prescribing an individualised daily exercise time, based on the time of CGM-derived peak glucose, for people with T2D. Thirty-five individuals with T2D (HbA1c: 7.2 ± 0.8%; age: 64 ± 7 y; BMI: 29.2 ± 5.2 kg/m2) were recruited and randomised to one of two 14 d exercise interventions: i) ExPeak (daily exercise starting 30 min before peak hyperglycaemia) or placebo active control NonPeak (daily exercise starting 90 min after peak hyperglycaemia). The time of peak hyperglycaemia was determined via a two-week baseline CGM. A CGM, accelerometer, and heart rate monitor were worn during the free-living interventions to objectively measure glycaemic control outcomes, moderate-to-vigorous intensity physical activity (MVPA), and exercise adherence for future translation in a clinical trial. Participation in MVPA increased 26% when an exercise time was prescribed compared to habitual baseline (p < 0.01), with no difference between intervention groups (p > 0.26). The total MVPA increased by 10 min/day during the intervention compared to the baseline (baseline: 23 ± 14 min/d vs. intervention: 33 ± 16 min/d, main effect of time p = 0.03, no interaction). The change in peak blood glucose (mmol/L) was similar between the ExPeak (-0.44 ± 1.6 mmol/L, d = 0.21) and the NonPeak (-0.39 ± 1.5 mmol/L, d = 0.16) intervention groups (p = 0.92). Prescribing an exercise time based on CGM may increase daily participation in physical activity in people with type 2 diabetes; however, further studies are needed to test the long-term impact of this approach.

Keywords: continuous glucose monitoring; hyperglycaemia; physical activity; prescribed exercise timing; type 2 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Exercise adherence (A) and total moderate-to-vigorous intensity physical activity (MVPA) (B) improved when an exercise time was prescribed. (A) Approximately 66% of participants completed ≥15 min of moderate intensity physical activity ≥5 days/week during the intervention compared to 40% of participants at baseline (p = 0.03), and (B) total MVPA increased by 10 min/day during the intervention compared to baseline (baseline: 23 ± 14 min/d vs. intervention: 33 ± 16 min/d, main effect of time p = 0.03 no interaction). * p = 0.03 between baseline and intervention. Values are mean ± SD, n = 33.
Figure 2
Figure 2
Mean and peak blood glucose levels (mmol/L) at baseline and during the two-week intervention. (A) Mean blood glucose was similar at baseline and during the intervention for the ExPeak (base: 7.66 ± 1.85 mmol/L, int: 7.51 ± 1.28 mmol/L, p = 0.56) and NonPeak (base: 7.27 ± 1.51, int: 7.03 ± 1.37 mmol/L, p = 0.35) groups. (B) The change in peak blood glucose (mmol/L) was similar between the ExPeak (−0.44 ± 1.6 mmol/L, Cohen’s d: 0.21) and NonPeak (−0.39 ± 1.5 mmol/L, Cohen’s d: 0.16) intervention groups (p = 0.92). Values are mean ± SD, n = 33.
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