Closing the loop on exercise in type 1 diabetes.
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Publisher DOI
PubMed ID
28245784
Description
BACKGROUND
Despite its well-established health benefits, exercise imposes challenges on glucose control in individuals with type 1 diabetes due to to the complex interactions between exercise-induced effects on glucose metabolism and exogenous insulin therapy. Although clinical guidelines for exercise management in type 1 diabetes are available, implementation is challenging in daily -life. The risk of exercise-induced dysglycaemia deters many people with type 1 diabetes from participating and benefiting from exercise. Rapid progress has been made in the development of closed-loop systems, also known as the artificial pancreas. The autonomous modulation of insulin delivery in a glucose-responsive manner by closed-loop systems may be beneficial in addressing and overcoming the risk and burden of exercise-induced dysglycaemia.
METHODS
A summative overview of closed-loop application during exercise in type 1 diabetes is discussed, outlining current evidence and limitations, our perspectives in the field and future outlook.
RESULTS
Outcomes from clinical studies evaluating both single- and dual-hormone closed-loop during exercise are reported. Current approaches to enhance closed-loop performance during exercise are described.
CONCLUSION
Closed-loop system has the potential to ameliorate exercise management in type 1 diabetes. Promising results have been shown, however innovative approaches are still needed to overcome inherent limitations of closed-loop performance during exercise. Future studies in larger generalizable patient population during real-life settings are still needed, to further evaluate its clinical applicability.
Despite its well-established health benefits, exercise imposes challenges on glucose control in individuals with type 1 diabetes due to to the complex interactions between exercise-induced effects on glucose metabolism and exogenous insulin therapy. Although clinical guidelines for exercise management in type 1 diabetes are available, implementation is challenging in daily -life. The risk of exercise-induced dysglycaemia deters many people with type 1 diabetes from participating and benefiting from exercise. Rapid progress has been made in the development of closed-loop systems, also known as the artificial pancreas. The autonomous modulation of insulin delivery in a glucose-responsive manner by closed-loop systems may be beneficial in addressing and overcoming the risk and burden of exercise-induced dysglycaemia.
METHODS
A summative overview of closed-loop application during exercise in type 1 diabetes is discussed, outlining current evidence and limitations, our perspectives in the field and future outlook.
RESULTS
Outcomes from clinical studies evaluating both single- and dual-hormone closed-loop during exercise are reported. Current approaches to enhance closed-loop performance during exercise are described.
CONCLUSION
Closed-loop system has the potential to ameliorate exercise management in type 1 diabetes. Promising results have been shown, however innovative approaches are still needed to overcome inherent limitations of closed-loop performance during exercise. Future studies in larger generalizable patient population during real-life settings are still needed, to further evaluate its clinical applicability.
Date of Publication
2018
Publication Type
Article
Subject(s)
Keyword(s)
artificial pancreas closed-loop exercise glucagon glucose control hypoglycaemia insulin type 1 diabetes
Language(s)
en
Series
Current diabetes reviews
Publisher
Bentham Science Publishers
ISSN
1875-6417
Access(Rights)
metadata.only