Dataset Information

Multivariable Artificial Pancreas for Various Exercise Types and Intensities.

ABSTRACT:

Background

Exercise challenges people with type 1 diabetes in controlling their glucose concentration (GC). A multivariable adaptive artificial pancreas (MAAP) may lessen the burden.

Methods

The MAAP operates without any user input and computes insulin based on continuous glucose monitor and physical activity signals. To analyze performance, 18 60-h closed-loop experiments with 96 exercise sessions with three different protocols were completed. Each day, the subjects completed one resistance and one treadmill exercise (moderate continuous training [MCT] or high-intensity interval training [HIIT]). The primary outcome is time spent in each glycemic range during the exercise + recovery period. Secondary measures include average GC and average change in GC during each exercise modality.

Results

The GC during exercise + recovery periods were within the euglycemic range (70-180?mg/dL) for 69.9% of the time and within a safe glycemic range for exercise (70-250?mg/dL) for 93.0% of the time. The exercise sessions are defined to begin 30?min before the start of exercise and end 2?h after start of exercise. The GC were within the severe hypoglycemia (<55?mg/dL), moderate hypoglycemia (55-70?mg/dL), moderate hyperglycemia (180-250?mg/dL), and severe hyperglycemia (>250?mg/dL) for 0.9%, 1.3%, 23.1%, and 4.8% of the time, respectively. The average GC decline during exercise differed with exercise type (P?=?0.0097) with a significant difference between the MCT and resistance (P?=?0.0075). To prevent large GC decreases leading to hypoglycemia, MAAP recommended carbohydrates in 59% of MCT, 50% of HIIT, and 39% of resistance sessions.

Conclusions

A consistent GC decline occurred in exercise and recovery periods, which differed with exercise type. The average GC at the start of exercise was above target (185.5?±?56.6?mg/dL for MCT, 166.9?±?61.9?mg/dL for resistance training, and 171.7?±?41.4?mg/dL HIIT), making a small decrease desirable. Hypoglycemic events occurred in 14.6% of exercise sessions and represented only 2.22% of the exercise and recovery period.

SUBMITTER: Turksoy K

PROVIDER: S-EPMC6161329 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Multivariable Artificial Pancreas for Various Exercise Types and Intensities.

Turksoy Kamuran K Hajizadeh Iman I Hobbs Nicole N Kilkus Jennifer J Littlejohn Elizabeth E Samadi Sediqeh S Feng Jianyuan J Sevil Mert M Lazaro Caterina C Ritthaler Julia J Hibner Brooks B Devine Nancy N Quinn Laurie L Cinar Ali A

Diabetes technology & therapeutics 20180906 10

<h4>Background</h4>Exercise challenges people with type 1 diabetes in controlling their glucose concentration (GC). A multivariable adaptive artificial pancreas (MAAP) may lessen the burden.<h4>Methods</h4>The MAAP operates without any user input and computes insulin based on continuous glucose monitor and physical activity signals. To analyze performance, 18 60-h closed-loop experiments with 96 exercise sessions with three different protocols were completed. Each day, the subjects completed one ...[more]

PMID: 30188192

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Project description:PurposeThis study aimed to investigate changes in cerebral hemodynamics and oxygenation at moderate, heavy, maximal and supramaximal intensities of rowing exercise. It also examined whether these changes reflect alterations in sensation of effort and mood. We also aimed to examine the effects of peak pulmonary oxygen consumption ( V. O2peak ) on cerebral oxygenation.MethodsEleven rowers, consisting out of six athletes and five recreational rowers [two female; age, 27 ± 9 years; height, 171 ± 7 cm, body mass, 67 ± 9 kg; V. O2peak , 53.5 ± 6.5 mL min-1 kg-1] rowed a 13-min session separated by 10 and 3 min, at 70 (Ex70%) and 80% of V. O2peak (Ex80%), respectively, on a rowing ergometer, followed by three sessions of 1-min supramaximal exercise (ExSp). After a warm-up at 60% of V. O2peak (ExM), seven male rowers performed a 2,000 m all-out test (Ex2000). Cardiovascular and respiratory variables were measured. Cerebral oxygenation was investigated by near-infrared time-resolved spectroscopy (TRS) to measure cerebral hemoglobin oxygen saturation (ScO2) and total hemoglobin concentration ([HbT]) in the prefrontal cortex (PFC) quantitatively. We estimated the relative changes from rest in cerebral metabolic rate for oxygen (rCMRO2) using TRS at all intensities. During Ex70% and Ex80%, ratings of perceived exertion (RPE) were monitored, and alteration of the subject's mood was evaluated using a questionnaire of Positive-and-Negative-Affect-Schedule after Ex70% and Ex80%.ResultsWhen exercise intensity changed from Ex70% to Ex80%, the sense of effort increased while ScO2 decreased. [HbT] remained unchanged. After Ex70% and Ex80%, a negative mood state was less prominent compared to rest and was accompanied by increases in both ScO2 and [HbT]. At termination of Ex2000, ScO2 decreased by 23% compared to rest. Changes in ScO2 correlated with V. O2peak only during Ex2000 (r = -0.86; p = 0.01). rCMRO2 did not decrease at any intensities.ConclusionOur results suggest that alterations in the sense of effort are associated with oxygenation in the PFC, while positive changes in mood status are associated with cerebral perfusion and oxygen metabolism estimated by TRS. At exhaustion, the cerebral metabolic rate for oxygen is maintained despite a decrease in ScO2.

Dataset Information

Multivariable Artificial Pancreas for Various Exercise Types and Intensities.

Background

Methods

Results

Conclusions

Publications

Multivariable Artificial Pancreas for Various Exercise Types and Intensities.

Similar Datasets

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