Emma G. Wilmot, Julia K. Mader, Simon Heller, Kirsten Nørgaard, Dessi P. Zaharieva, Tadej Battelino, Othmar Moser, Carine de Beaufort, Christoph Stettler, Hood Thabit, Martin Tauschmann, Pieter Gillard, Harald Sourij, Asma Deeb, Tim Heise, Peter Adolfsson, Chantal Mathieu, Carmel E. Smart, Nick Oliver, Lalantha Leelarathna, Bruce A. Buckingham, Aaron J. Kowalski, Louisa van den Boom, Richard M. Bergenstal, Eda Cengiz, Max L. Eckstein, Peter G. Jacobs, Michael C. Riddell, Richard M. Bracken, and Rémi Rabasa-Lhoret
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.