Adding heart rate signal to a control-to-range artificial pancreas system improves the protection against hypoglycemia during exercise in type 1 diabetes.

Abstract Background: We present a clinical trial establishing the feasibility of a control-to-range (CTR) closed-loop system informed by heart rate (HR) and assess the effect of HR information added to CTR on the risk for hypoglycemia during and after exercise. Subjects and Methods: Twelve subjects with type 1 diabetes (five men, seven women; weight, 68.9±3.1 kg; age, 38±3.3 years; glycated hemoglobin, 6.9±0.2%) participated in a randomized crossover clinical trial comparing CTR versus CTR+HR in two 26-h admissions, each including 30 min of mild exercise. The CTR algorithm was implemented in the DiAs portable artificial pancreas platform based on an Android® (Google, Mountainview, CA) smartphone. We assessed blood glucose (BG) decline during exercise, the Low BG Index (LBGI) (a measure of hypoglycemic risk), number of hypoglycemic episodes (BG <70 mg/dL) and overall glucose control (percentage time within the target range 70 mg/dL≤BG≤180 mg/dL). Results: Using HR to inform the CTR algorithm reduced signif...

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