Continuous glucose monitor (CGM) and exercise 24 April 2017 BEAT IT Gym: Lori’s Story Managing blood glucose levels is just one of many key reasons to exercise. But what if you have type 1 diabetes, your levels are erratic and you want to get back into exercise? The benefits of exercise far outweigh the risks, however it is important understand how your levels respond to different types of exercise to reduce your risk of hypoglycaemic episodes. As the name suggests, the recent invention of the Continuous Glucose Monitor (CGM) can be of great assistance in this instance. CGM is a blood glucose sensor, which is attached to a site on the stomach allows for 24 hour feedback of blood glucose levels to a transmitter. This allows the user to see what their level is at that moment in time, and information on which way their blood glucose level is trending (up or down). It does require daily calibration with two finger prick tests, but this can be considered a blessing if you usually have to prick your finger at least 10 times a day. Last year, one of our BEAT IT participants living with type 1 diabetes was able to trial a CGM for a week. Lori, a 54 year old female with type 1 diabetes had joined the BEAT IT program hoping to get some more skills around how to exercise and to improve her HbA1c. She had been managing the condition for 48 years, so essentially her whole life! As a result of diabetes, Lori has some long term complications including peripheral neuropathy and retinopathy “I can’t read print, so I use a computer that talks to me, and I can’t see enough to get around without using a white cane”. Lori was no stranger to physical activity. She spent many years training in Japanese martial arts, walks regularly and kayaks on the ocean a few times a week with friends. “I like challenging myself, especially through developing new skills in physical activity.” Lori’s blood glucose levels were constantly fluctuating, with no clear pattern detected from finger prick tests. She was not getting the full picture. With the help of Rebecca from Animas, Lori trialled the DEXCOM 4 CGM for seven days. “It was really valuable. It gave a really clear picture of what my blood glucose levels were doing over the 24 hours. It was great to be able to look at the receiver and see what my levels were at any given time. For example, if I was in a meeting and I was hungry, was I hungry because my level was low or was I just hungry? It was also great because I didn’t need to do so many finger pricks during the day,” Lori recounted. With regards to diabetes management, the CGM was able to help Lori’s diabetes team to understand medication adjustments that needed to be made. In this instance, “I was able to increase insulin basal rates, which has improved my levels through the day”. By the end of the 8 week BEAT IT program, Lori’s HbA1c dropped from 10.2% to 8.6%. She also reduced her weight by 1.2kg and waist circumference by 3cm. The downside to the CGM? “Having to still do two finger prick tests to calibrate the device daily, but that’s hardly anything to complain about” Speak with your diabetes team for more information around this technology and if it is suitable for you.