Heart rate informed artificial pancreas system enhances glycemic control during exercise in adolescents with T1D. Issue 7 (13th October 2016)

• Record Type: Journal Article
• Authors: DeBoer, Mark D.; Cherñavvsky, Daniel R.; Topchyan, Katarina; Kovatchev, Boris P.; Francis, Gary L.; Breton, Marc D.
• Is Part Of: Pediatric diabetes. Volume 18:Issue 7(2017)
• Page Start: 540
• Page End: 546
• Publication Date: 2016-10-13
• Subjects: artificial pancreas -- exercise -- heart rate -- monitor -- type 1 diabetes; Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12454
• Languages: English
• ISSNs: 1399-543X

Abstract

Abstract : Objective: To evaluate the safety and performance of using a heart rate (HR) monitor to inform an artificial pancreas (AP) system during exercise among adolescents with type 1 diabetes (T1D). Materials and Methods: In a randomized, cross‐over trial, adolescents with T1D age 13 ‐ 18 years were enrolled to receive on separate days either the unmodified UVa AP (stdAP) or an AP system connected to a portable HR monitor (AP‐HR) that triggered an exercise algorithm for blood glucose (BG) control. During admissions participants underwent a structured exercise regimen. Hypoglycemic events and CGM tracings were compared between the two admissions, during exercise and for the full 24‐hour period. Results: Eighteen participants completed the trial. While number of hypoglycemic events during exercise and rest was not different between visits (0.39 AP‐HR vs 0.50 stdAP), time below 70 mg dL −1 was lower on AP‐HR compared to stdAP, 0.5±2.1% vs 7.4±12.5% ( P = 0.028). Time with BG within 70‐180 mg dL −1 was higher for the AP‐HR admission vs stdAP during the exercise portion and overall (96% vs 87%, and 77% vs 74%), but these did not reach statistical significance ( P = 0.075 and P = 0.366). Conclusions: Heart rate signals can safely and efficaciously be integrated in a wireless AP system to inform of physical activity. While exercise contributes to hypoglycemia among adolescents, even when using an AP system, informing the system of exercise via a HR monitor improved time <70 mg dL −1 . Nonetheless, it did not significantly reduce the total number of hypoglycemic events, which were low in both groups.