المؤلفون: Florian H. Guillot, Peter G. Jacobs, Leah M. Wilson, Joseph El Youssef, Virginia B. Gabo, Deborah L. Branigan, Nichole S. Tyler, Katrina Ramsey, Michael C. Riddell, Jessica R. Castle

المصدر: Biosensors, Vol 10, Iss 10, p 138 (2020)

مصطلحات موضوعية: continuous glucose monitoring, type 1 diabetes, exercise, glucose sensor accuracy, high intensity interval training, aerobic exercise, Biotechnology, TP248.13-248.65

الوصف: The accuracy of continuous glucose monitoring (CGM) sensors may be significantly impacted by exercise. We evaluated the impact of three different types of exercise on the accuracy of the Dexcom G6 sensor. Twenty-four adults with type 1 diabetes on multiple daily injections wore a G6 sensor. Participants were randomized to aerobic, resistance, or high intensity interval training (HIIT) exercise. Each participant completed two in-clinic 30-min exercise sessions. The sensors were applied on average 5.3 days prior to the in-clinic visits (range 0.6–9.9). Capillary blood glucose (CBG) measurements with a Contour Next meter were performed before and after exercise as well as every 10 min during exercise. No CGM calibrations were performed. The median absolute relative difference (MARD) and median relative difference (MRD) of the CGM as compared with the reference CBG did not differ significantly from the start of exercise to the end exercise across all exercise types (ranges for aerobic MARD: 8.9 to 13.9% and MRD: −6.4 to 0.5%, resistance MARD: 7.7 to 14.5% and MRD: −8.3 to −2.9%, HIIT MARD: 12.1 to 16.8% and MRD: −14.3 to −9.1%). The accuracy of the no-calibration Dexcom G6 CGM was not significantly impacted by aerobic, resistance, or HIIT exercise.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2079-6374/10/10/138Test; https://doaj.org/toc/2079-6374Test

الوصول الحر: https://doaj.org/article/24cfba3912074fc59674f38180acf2d5Test

المؤلفون: Virginia Gabo, Ravi Reddy, Peter G. Jacobs, Deborah Branigan, Brian Senf, Navid Resalat, Florian H. Guillot, Katrina Ramsey, Nichole S. Tyler, Jessica R. Castle, Joseph El Youssef, Joseph Leitschuh, Isabelle Isa Kristin Steineck, Leah M. Wilson

المصدر: Diabetes Care. 43:2721-2729

مصطلحات موضوعية: Adult, Blood Glucose, Male, Pancreas, Artificial, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Urology, 030209 endocrinology & metabolism, Hypoglycemia, Artificial pancreas, Glucagon, Oregon, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Diabetes mellitus, Outpatients, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Exercise physiology, Exercise, Advanced and Specialized Nursing, Type 1 diabetes, Cross-Over Studies, business.industry, Middle Aged, medicine.disease, Crossover study, Diabetes Mellitus, Type 1, Hyperglycemia, Feasibility Studies, Female, business

الوصف: OBJECTIVE To assess the efficacy and feasibility of a dual-hormone (DH) closed-loop system with insulin and a novel liquid stable glucagon formulation compared with an insulin-only closed-loop system and a predictive low glucose suspend (PLGS) system. RESEARCH DESIGN AND METHODS In a 76-h, randomized, crossover, outpatient study, 23 participants with type 1 diabetes used three modes of the Oregon Artificial Pancreas system: 1) dual-hormone (DH) closed-loop control, 2) insulin-only single-hormone (SH) closed-loop control, and 3) PLGS system. The primary end point was percentage time in hypoglycemia ( RESULTS DH reduced hypoglycemia compared with SH during and after exercise (DH 0.0% [interquartile range 0.0–4.2], SH 8.3% [0.0–12.5], P = 0.025). There was an increased time in hyperglycemia (>180 mg/dL) during and after exercise for DH versus SH (20.8% DH vs. 6.3% SH, P = 0.038). Mean glucose during the entire study duration was DH, 159.2; SH, 151.6; and PLGS, 163.6 mg/dL. Across the entire study duration, DH resulted in 7.5% more time in target range (70–180 mg/dL) compared with the PLGS system (71.0% vs. 63.4%, P = 0.044). For the entire study duration, DH had 28.2% time in hyperglycemia vs. 25.1% for SH (P = 0.044) and 34.7% for PLGS (P = 0.140). Four participants experienced nausea related to glucagon, leading three to withdraw from the study. CONCLUSIONS The glucagon formulation demonstrated feasibility in a closed-loop system. The DH system reduced hypoglycemia during and after exercise, with some increase in hyperglycemia.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::239d793cfe1b212548d7861dba424a0dTest
https://doi.org/10.2337/dc19-2267Test

المؤلفون: Peter G. Jacobs, Nichole S. Tyler, Joseph El Youssef, Navid Resalat, Jessica R. Castle, Wade Hilts

المصدر: J Diabetes Sci Technol

مصطلحات موضوعية: Blood Glucose, Pancreas, Artificial, medicine.medical_specialty, Adaptive control, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 0206 medical engineering, Biomedical Engineering, 030209 endocrinology & metabolism, Bioengineering, 02 engineering and technology, Models, Biological, Artificial pancreas, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Internal medicine, Accelerometry, Heart rate, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Computer Simulation, Exercise, Type 1 diabetes, business.industry, System identification, Postprandial Period, medicine.disease, 020601 biomedical engineering, Model predictive control, Diabetes Mellitus, Type 1, Postprandial, Cardiology, Special Section: Artificial Pancreas, business, Algorithms

الوصف: Background: People with type 1 diabetes (T1D) have varying sensitivities to insulin and also varying responses to meals and exercise. We introduce a new adaptive run-to-run model predictive control (MPC) algorithm that can be used to help people with T1D better manage their glucose levels using an artificial pancreas (AP). The algorithm adapts to individuals’ different insulin sensitivities, glycemic response to meals, and adjustment during exercise as a continuous input during free-living conditions. Methods: A new insulin sensitivity adaptation (ISA) algorithm is presented that updates each patient’s insulin sensitivity during nonmeal periods to reduce the error between the actual glucose levels and the process model. We further demonstrate how an adaptive learning postprandial hypoglycemia prevention algorithm (ALPHA) presented in the previous work can complement the ISA algorithm, and the algorithm can adapt in several days. We further show that if physical activity is incorporated as a continuous input (heart rate and accelerometry), performance is improved. The contribution of this work is the description of the ISA algorithm and the evaluation of how ISA, ALPHA, and incorporation of exercise metrics as a continuous input can impact glycemic control. Results: Incorporating ALPHA, ISA, and physical activity into the MPC improved glycemic outcome measures. The adaptive learning postprandial hypoglycemia prevention algorithm combined with ISA significantly reduced time spent in hypoglycemia by 71.7% and the total number of rescue carbs by 67.8% to 0.37% events/day/patient. Insulin sensitivity adaptation significantly reduced model-actual mismatch by 12.2% compared to an AP without ISA. Incorporating physical activity as a continuous input modestly improved time in the range 70 to 180 mg/dL during high physical activity days from 84.4% to 84.9% and reduced the percentage time in hypoglycemia by 23.8% from 2.1% to 1.6%. Conclusion: Adapting postprandial insulin delivery, insulin sensitivity, and adapting to physical exercise in an MPC-based AP systems can improve glycemic outcomes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7ede8a9145943dd4828fdf0932b2052bTest
https://doi.org/10.1177/1932296819881467Test

المؤلفون: Virginia Gabo, Jessica R. Castle, Peter G. Jacobs, Katrina Ramsey, Nichole S. Tyler, Leah M. Wilson, Florian H. Guillot, Deborah Branigan, Joseph El Youssef, Michael C. Riddell

المصدر: Biosensors
Volume 10
Issue 10
Biosensors, Vol 10, Iss 138, p 138 (2020)

مصطلحات موضوعية: Blood Glucose, medicine.medical_specialty, type 1 diabetes, lcsh:Biotechnology, Clinical Biochemistry, high intensity interval training, 030209 endocrinology & metabolism, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, lcsh:TP248.13-248.65, Medicine, Aerobic exercise, Humans, 030212 general & internal medicine, Type 1 diabetes, exercise, Continuous glucose monitoring, business.industry, Blood Glucose Self-Monitoring, Resistance training, General Medicine, medicine.disease, aerobic exercise, resistance exercise, Diabetes Mellitus, Type 1, Calibration, Cardiology, glucose sensor accuracy, continuous glucose monitoring, business, High-intensity interval training

الوصف: The accuracy of continuous glucose monitoring (CGM) sensors may be significantly impacted by exercise. We evaluated the impact of three different types of exercise on the accuracy of the Dexcom G6 sensor. Twenty-four adults with type 1 diabetes on multiple daily injections wore a G6 sensor. Participants were randomized to aerobic, resistance, or high intensity interval training (HIIT) exercise. Each participant completed two in-clinic 30-min exercise sessions. The sensors were applied on average 5.3 days prior to the in-clinic visits (range 0.6&ndash
9.9). Capillary blood glucose (CBG) measurements with a Contour Next meter were performed before and after exercise as well as every 10 min during exercise. No CGM calibrations were performed. The median absolute relative difference (MARD) and median relative difference (MRD) of the CGM as compared with the reference CBG did not differ significantly from the start of exercise to the end exercise across all exercise types (ranges for aerobic MARD: 8.9 to 13.9% and MRD: &minus
6.4 to 0.5%, resistance MARD: 7.7 to 14.5% and MRD: &minus
8.3 to &minus
2.9%, HIIT MARD: 12.1 to 16.8% and MRD: &minus
14.3 to &minus
9.1%). The accuracy of the no-calibration Dexcom G6 CGM was not significantly impacted by aerobic, resistance, or HIIT exercise.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1482c54ed1c82be81388628329cb0064Test
http://europepmc.org/articles/PMC7600074Test