Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: A randomized clinical trial

Abstract

Aims-Despite the known benefits, 60% of individuals with diabetes do not engage in regular physical activity (PA). This pilot study tested the effects of a counseling intervention using continuous glucose monitoring system (CGMS) feedback on PA self-efficacy, PA levels, and physiological variables.Methods-Adults (N = 52) with type 2 diabetes (non-insulin requiring, inactive) were randomized to intervention (n = 27) or control (n = 25) groups. Both groups received 90 min of diabetes education with a follow-up phone call 4 weeks later. The intervention group also received counseling derived from self-efficacy theory. This intervention included feedback on each participant's CGMS graph and used role model CGMS graphs to clearly depict glucose reductions in response to PA. Outcomes were assessed at baseline and 8 weeks.Results-Participants receiving the intervention had higher self-efficacy scores than the control group for sticking to activity/resisting relapse at 8 weeks (p < 0.05), indicating more confidence in maintaining a PA program. Intervention group participants light/sedentary activity minutes decreased significantly (p < 0.05), moderate activity minutes increased significantly (p < 0.05), and, HbA1c and BMI decreased significantly (p < 0.05).Conclusions-These data suggest that PA counseling interventions using CGMS feedback for individuals with type 2 diabetes may improve PA levels and reduce risk factors for diabetes-related complications.

Clinical Use of Continuous Glucose Monitoring in Adults with Type 2 Diabetes

“…8 Even in patients not on insulin, there is demonstrated benefit to RT-CGM use and HbA1c reduction, presumably from improved lifestyle and behavior changes. 9 Other groups have also described a potential benefit through changing lifestyle and patient motivation to achieve glycemic goals. 10 RT-CGM also appears to be more beneficial in those with higher starting HbA1c.…”

Continuous Glucose Monitoring: Evidence and Consensus Statement for Clinical Use

“…[41][42][43] Various RCTs have also been carried out in which the investigation was geared toward treatments and methods with a diagnostic background, and in these instances, CGM supported the assessment of these interventions. [44][45][46] A typical example of this is the detection of nocturnal hypoglycemic episodes. 47 The situation is fundamentally different with "open," real-time use of CGM.…”

Unblinded CGM Should Replace Blinded CGM in the Clinical Management of Diabetes

“…However, providers continue to use blinded CGM during short-term wear periods despite inconclusive evidence. [9][10][11] This article highlights why the advent of real-time, unblinded CGM obviates the need for blinded CGM in all settings other than a formal clinical research study.…”