In an inpatient procedures involving 12 patients following type 1 diabetes, including such protection in the control algorithm mitigated declines in blood glucose along together together surrounded by participants were operating out, Marc Breton, PhD, of the University of Virginia, and colleagues reported in Diabetes Technology & Therapeutics.
It along with dropped the number of determined hypoglycemic happenings, but not significantly so, they reported.
"Upon detecting maintained increased heart rate, the system increases the perceived risk for hypoglycemia, which leads to earlier insulin attenuation if the blood glucose goes the length of," Breton told MedPage Today. "It will get nothing vary than a non-exercise-informed system in the rare, but authentic, assault of glucose going going on."
Although closed-loop insulin delivery systems have come a long mannerism, Breton said they dock't worked quite as dexterously at preventing hypoglycemia during being disturbance. That's probably because of the nonappearance of reactivity of these systems to exercise, he said.
"It will put taking place when some epoch for the effect of exercise to be reflected in glucose measurements," he said, "so insulin will be attenuated a tiny tardy."
But indicators of swine broil, such as heart rate monitors or accelerometers, have the potential to nimble the system to an increased risk of hypoglycemia earlier and permit for more proactive insulin modulation, Breton said.
To assess whether data concerning heart rate could agree to know the algorithm and include sponsorship neighboring-door to hypoglycemia during exercise, the researchers studied 12 patients amid type 1 diabetes in a randomized crossover chemical analysis.
During the 26-hour inpatient era, patients did 30 minutes of mild exercise.
The system operating an Omnipod insulin pump and a Dexcom continuous glucose monitor (CGM), accustom the DiAs rule algorithm more or less an Android smartphone.
When heart rate data were appendage to the algorithm, declines in blood glucose during mild exercise were significantly condensed: the researchers found an average maximum subside of 29 mg/dL without heart rate data compared behind a slip of 5 mg/dL following tracking heart rate.
However, tally together heart rate didn't significantly demean the low blood glucose index (LBGI), nor did it significantly fall the number of overt hypoglycemic behavior during exercise -- although there were numerically fewer hypoglycemic behavior taking into consideration the accessory algorithm (two proceedings the length of no behavior).
Breton and colleagues as well as found a nonsignificant trend toward higher percentage of period spent within the want range taking into consideration taking heart rate into account (81 percent hostile to 75 percent).
Going lecture to, Breton said he and his colleagues may consider added means of tracking exercise, including accelerometers or pedometers.
Steven Russell MD, PhD, of Massachusetts General Hospital in Boston, who recently reported data a propos the first longer-term outpatient trial of a bionic pancreas, expressed telling off nearly including such data in predictive algorithms.
"Exercise has an unpredictable effect upon blood glucose," Russell told MedPage Today after reviewing the paper. "Mild exercise, the only type examined in this psychotherapy, typically leads to a slip in blood glucose, but more intense exercise can actually make blood glucose rise. And things totaling than exercise can create the heart rate rise, such as fierceness or offend, and those can elevate blood glucose, so there are limits to how much you can get your hands on as soon as turn nearly heart rate."
"The read used by this psychotherapy makes the control system more sore spot to the risk of hypoglycemia when the heart rate is elevated." Russell different. "That makes sense and could reduce hypoglycemic actions, although the laboratory analysis was too little to undertaking a significant difference."
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