Multivariable Artificial Pancreas for Various Exercise Types and Intensities
| Autor: | Jennifer M. Kilkus, Sediqeh Samadi, Ali Cinar, Elizabeth Littlejohn, Jianyuan Feng, Brooks Hibner, Nicole Hobbs, Caterina Lazaro, Iman Hajizadeh, Kamuran Turksoy, Laurie Quinn, Mert Sevil, Nancy Devine, Julia Ritthaler |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Blood Glucose Male Pancreas Artificial medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Artificial pancreas 03 medical and health sciences chemistry.chemical_compound Young Adult 0302 clinical medicine Endocrinology Internal medicine Diabetes mellitus medicine Humans Hypoglycemic Agents Insulin 030212 general & internal medicine Exercise Infusion Pumps Type 1 diabetes business.industry Multivariable calculus Blood Glucose Self-Monitoring Resistance Training Meth Original Articles medicine.disease Hypoglycemia Medical Laboratory Technology Diabetes Mellitus Type 1 Treatment Outcome chemistry Female business |
| Popis: | Background: Exercise challenges people with type 1 diabetes in controlling their glucose concentration (GC). A multivariable adaptive artificial pancreas (MAAP) may lessen the burden. Methods: The MAAP operates without any user input and computes insulin based on continuous glucose monitor and physical activity signals. To analyze performance, 18 60-h closed-loop experiments with 96 exercise sessions with three different protocols were completed. Each day, the subjects completed one resistance and one treadmill exercise (moderate continuous training [MCT] or high-intensity interval training [HIIT]). The primary outcome is time spent in each glycemic range during the exercise + recovery period. Secondary measures include average GC and average change in GC during each exercise modality. Results: The GC during exercise + recovery periods were within the euglycemic range (70–180 mg/dL) for 69.9% of the time and within a safe glycemic range for exercise (70–250 mg/dL) for 93.0% of the time. The exercise sessions are defined to begin 30 min before the start of exercise and end 2 h after start of exercise. The GC were within the severe hypoglycemia (250 mg/dL) for 0.9%, 1.3%, 23.1%, and 4.8% of the time, respectively. The average GC decline during exercise differed with exercise type (P = 0.0097) with a significant difference between the MCT and resistance (P = 0.0075). To prevent large GC decreases leading to hypoglycemia, MAAP recommended carbohydrates in 59% of MCT, 50% of HIIT, and 39% of resistance sessions. Conclusions: A consistent GC decline occurred in exercise and recovery periods, which differed with exercise type. The average GC at the start of exercise was above target (185.5 ± 56.6 mg/dL for MCT, 166.9 ± 61.9 mg/dL for resistance training, and 171.7 ± 41.4 mg/dL HIIT), making a small decrease desirable. Hypoglycemic events occurred in 14.6% of exercise sessions and represented only 2.22% of the exercise and recovery period. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|