Adaptive Physical Therapy Interventions Using Real-time Glycemic Feedback From Dexcom G7 CGM In Elderly Diabetics

Adaptive Physical Therapy Interventions Using Real-Time Glycemic Feedback FromDexcom G7 CGM In Elderly DiabeticsSurabhi Naik, MS, Exercise Science; Ricardo Mora-Rodriguez, FACSM PURPOSE: Elderly individuals with type 2 diabetes face exercise-induced hypoglycemia and hyperglycemia,yet traditional physical therapy lacks real-time glucose monitoring to prevent fluctuations. Thisstudy evaluates the effectiveness of Continuous Glucose Monitoring (CGM) guided adaptiveexercise therapy, integrating real-time feedback for safer and more effective training. METHODS: A six-week pre-post-trial (no control group) with 20 diabetic participants (≥65 years) included tensupervised exercise sessions (30–45 minutes). Exercises included: Warm-Up (Mobility; SpotMarching); Aerobic Activity: (Seated / Chair stepping, Treadmill); Strength & FunctionalTraining: Chair squats, Wall push-ups, Resistance band, grip strengthening); Cool-Down:(Stretching and breathing exercises). CGM-based adjustments ensured glucose remained within70–180 mg/dL, modifying intensity as needed. RESULTS: Paired t-tests were used to compare pre and post intervention outcomes, with statisticalsignificance set at p < 0.05. Glucose stability was significantly improved, with hypoglycemiadecreasing by 23% and hyperglycemia by 18% (p < 0.05). Time in the target glucose rangeincreased from 60% to 80% (p < 0.05). Muscle strength improved (23.8 ± 2.6 kg to 30.2 ± 3.1 kg,p < 0.05). Functional mobility, assessed using the Timed Up & Go test, improved as completiontime decreased from 14.3 ± 1.2 s to 12.4 ± 1.0 s (p < 0.05). WHO-QOL scores significantlyimproved (p < 0.05) reflecting greater confidence in exercise safety and overall well-being. CONCLUSION: This study demonstrates the feasibility of CGM-guided adaptive physical therapy, improvingglycemic control, strength, and mobility in elderly diabetics. Findings support integrating CGMinto clinical rehabilitation. Future research should refine CGM-driven exercise protocols fordiabetes management. KEYWORDS: Continuous Glucose Monitor (CGM), Adaptive Exercise, Diabetes, GlycemicControl.