Heart rate informed artificial pancreas system enhances glycemic control during exercise in adolescents with T1D

Mark D. DeBoer, Daniel R. Cherñavvsky, Katarina Topchyan, Boris P. Kovatchev, Gary L. Francis, Marc D. Breton

Research output: Contribution to journalArticle

34 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)540-546
Number of pages7
JournalPediatric Diabetes
Volume18
Issue number7
DOIs
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • artificial pancreas
  • exercise
  • heart rate
  • monitor
  • type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

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