Exercise snacks to combat hyperglycaemia in patients with abnormal glycaemic control: Use of a novel strategy based on individual continuous glucose data in a real-world setting

AIM: To investigate the effectiveness and feasibility of continuous glucose monitoring (CGM)-guided exercise snacks (ES) to reduce time in individual hyperglycaemia in individuals with abnormal glycaemic control in a real-world setting. METHODS: Twenty-five participants (56 ± 10 years; HbA1c ≥ 5.7%) underwent four consecutive 3-day experimental periods separated by 4-day washout periods. They were instructed to continue their daily living under the following conditions: (a) without exercise (CONTROL), (b) performing ES whenever individualised CGM-derived hyperglycaemia alarms occurred (CGM-ES), (c) performing the same number of ES at fixed times without CGM (NON-CGM-ES), and (d) performing a once-daily long exercise session (cumulative ES time) (SINGLE-EX). RESULTS: Time spent in individual hyperglycaemia over 72 h differed significantly between experimental conditions (p < 0.001). It was more than a third reduced with both CGM-ES and NON-CGM-ES compared with CONTROL or SINGLE-EX. Adherence was high: 85% (CGM-ES), 88% (NON-CGM-ES), and 93% (SINGLE-EX). Intentions to continue CGM-ES, NON-CGM-ES, and SINGLE-EX differed significantly (p = 0.042), with CGM-ES and SINGLE-EX showing the highest mean scores on the 5-point Likert scale. CONCLUSIONS: The results suggest that regular ES reduce time in individual hyperglycaemia more effectively than a single long exercise session. CGM-ES may enhance motivation and facilitate rapid attenuation of hyperglycaemia in a real-world setting.