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Nutrients 2018, 10(1), 93;

Interstitial Glucose and Physical Exercise in Type 1 Diabetes: Integrative Physiology, Technology, and the Gap In-Between

Diabetes Research Group, Medical School, Swansea University, Swansea SA2 8PP, UK
Applied Sport, Technology, Exercise and Medicine Research Centre (A-STEM), College of Engineering, Swansea University, Swansea SA1 8EN, UK
Kinesiology, Sport and Recreation, Social Sciences, University of Alberta, Edmonton, AB T4V 2R3, Canada
Author to whom correspondence should be addressed.
Received: 27 November 2017 / Revised: 11 January 2018 / Accepted: 12 January 2018 / Published: 15 January 2018
(This article belongs to the Special Issue Carbohydrate Metabolism in Health and Disease)
Full-Text   |   PDF [420 KB, uploaded 15 January 2018]


Continuous and flash glucose monitoring systems measure interstitial fluid glucose concentrations within a body compartment that is dramatically altered by posture and is responsive to the physiological and metabolic changes that enable exercise performance in individuals with type 1 diabetes. Body fluid redistribution within the interstitial compartment, alterations in interstitial fluid volume, changes in rate and direction of fluid flow between the vasculature, interstitium and lymphatics, as well as alterations in the rate of glucose production and uptake by exercising tissues, make for caution when interpreting device read-outs in a rapidly changing internal environment during acute exercise. We present an understanding of the physiological and metabolic changes taking place with acute exercise and detail the blood and interstitial glucose responses with different forms of exercise, namely sustained endurance, high-intensity, and strength exercises in individuals with type 1 diabetes. Further, we detail novel technical information on currently available patient devices. As more health services and insurance companies advocate their use, understanding continuous and flash glucose monitoring for its strengths and limitations may offer more confidence for patients aiming to manage glycemia around exercise. View Full-Text
Keywords: continuous glucose monitoring; flash glucose monitoring; exercise; interstitium continuous glucose monitoring; flash glucose monitoring; exercise; interstitium
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Moser, O.; Yardley, J.E.; Bracken, R.M. Interstitial Glucose and Physical Exercise in Type 1 Diabetes: Integrative Physiology, Technology, and the Gap In-Between. Nutrients 2018, 10, 93.

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