Premium
Heart rate informed artificial pancreas system enhances glycemic control during exercise in adolescents with T1D
Author(s) -
DeBoer Mark D.,
Cherñavvsky Daniel R.,
Topchyan Katarina,
Kovatchev Boris P.,
Francis Gary L.,
Breton Marc D.
Publication year - 2017
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12454
Subject(s) - medicine , glycemic , heart rate , regimen , hypoglycemia , type 1 diabetes , randomized controlled trial , artificial pancreas , statistical significance , diabetes mellitus , physical therapy , cardiology , insulin , blood pressure , endocrinology
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.