Continuous glucose monitoring use is associated with higher physical activity in adults with type 1 diabetes: a nationwide cross-sectional study

Background Physical activity is a key component of type 1 diabetes (T1D) management, yet many adults do not achieve recommended activity levels. Continuous glucose monitoring (CGM) may reduce glycemic uncertainty during exercise; however, its association with real-world physical activity remains unclear. Objective To examine whether CGM use is independently associated with physical activity and to identify psychological factors related to perceived exercise facilitation among CGM users. Methods In this nationwide cross-sectional study, 368 adults with self-reported T1D in Lithuania (197 CGM users and 171 non-users) completed the International Physical Activity Questionnaire–Short Form (IPAQ-SF). Multivariable linear and logistic regression models adjusted for demographic and clinical covariates were used to evaluate associations between CGM use and physical activity outcomes. Among CGM users, logistic regression was applied to identify factors associated with perceived facilitation of physical activity. Results CGM users reported higher total physical activity (median 427.5 vs. 270 min/week, p = 0.001) and were more likely to engage in any moderate-to-vigorous physical activity (adjusted OR 4.4, 95% CI 2.2–8.0, p = 0.001) and to achieve ≥ 600 MET-min/week (adjusted OR 2.2, 95% CI 1.2–4.5, p = 0.035). Associations remained significant after adjustment for acute and chronic diabetes-related complications. Among CGM users, trust in CGM accuracy during exercise was strongly associated with perceived facilitation (adjusted OR 9.2, 95% CI 2.2–23.0, p = 0.008), whereas higher emotional diabetes-related distress was inversely associated (adjusted OR 0.65, 95% CI 0.44–0.90, p = 0.04). Conclusions CGM use was independently associated with higher physical activity levels in adults with T1D. Psychological factors, particularly technology-related trust and emotional distress, may contribute to differences in perceived exercise facilitation among CGM users. These findings should be interpreted as associative rather than causal.