Review of “Continuous Glucose Monitoring and Glycemic Metrics During Physical Activity in Individuals With Type 1 Diabetes”

Introduction: Type 1 diabetes requires continuous monitoring of blood glucose levels and careful adjustment of insulin therapy to maintain optimal metabolic control. Physical activity is widely recommended for individuals with type 1 diabetes due to its beneficial effects on metabolic health and cardiovascular risk reduction; however, exercise may lead to significant fluctuations in blood glucose levels, including both hypoglycemia and hyperglycemia. Continuous glucose monitoring (CGM) systems have emerged as an important technological advancement that enables real-time assessment of glucose variability and supports safer participation in physical activity. The glycemic impact of exercise differs according to exercise type, with aerobic activity more often associated with falling glucose levels and anaerobic or mixed activity showing greater variability [5]. Objective: To review the current scientific literature on the use of continuous glucose monitoring systems and CGM-derived glycemic metrics during physical activity in individuals with type 1 diabetes. Methods: A narrative review of scientific literature was conducted using PubMed/MEDLINE, Scopus, and Embase databases. Clinical studies, review articles, and consensus statements published between 1993 and 2026 were analyzed. The review focused on the role of CGM systems and glycemic metrics, such as Time in Range (TIR), Time Below Range (TBR), and Time Above Range (TAR), in assessing glucose control during physical activity. Conclusions: Continuous glucose monitoring systems significantly improve the ability to assess glycemic variability and support safer management of physical activity in individuals with type 1 diabetes. The use of CGM-derived metrics, particularly Time in Range, provides valuable insights into glucose dynamics during exercise and may contribute to better therapy individualization. Integration of CGM technology with modern diabetes management strategies represents an important step toward improving metabolic control and enhancing patient safety.