Aim: To assess an artificial pancreas system during aerobic (AeE) and anaerobic exercise (AnE).
Methods: A pilot clinical trial on five subjects with type 1 diabetes (4 males) aged 37±10.9 years, diabetes diagnosed 21.2±12.2 years before, insulin pump users, and with a mean HbA level of 7.8±0.5%. Every subject did three AeE and three AnE sessions. Blood glucose levels were monitored by the artificial pancreas system during exercise and up to four hours later. Before the start of exercise, 23g of carbohydrates were administered orally.
Results: The mean glucose level was 124.0±25.1mg/dL in the AeE studies and 152.1±34.1mg/dL in the AnE studies. Percent times in the different glucose ranges of 70-180, >180 and <70mg/dL were 89.8±18.6% and 75.9±27.6%; 7.7±18.4% and 23.2±28.0%; and 2.5±6.3% and 1.0±3.6% during the AeE and AnE sessions, respectively. Only six rescues with carbohydrates (15g) were required during the studies (4 in AeE and 2 in AnE). Total insulin dose during the five hours of the study was 3.1±1.0IU in the AeE studies and 3.5±1.3IU in the AnE studies.
Conclusions: Blood glucose response to AeE and AnE exercise is different. The evaluated artificial pancreas system appeared to achieve effective and safe blood glucose control during exercise and up to four hours later. However, new control strategies that minimize patient intervention should be designed.
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http://dx.doi.org/10.1016/j.endinu.2017.12.012 | DOI Listing |
PLoS One
January 2025
Institute of Visual Informatics, The National University of Malaysia (UKM), Bangi, Malaysia.
Patients with type 1 diabetes and their physicians have long desired a fully closed-loop artificial pancreas (AP) system that can alleviate the burden of blood glucose regulation. Although deep reinforcement learning (DRL) methods theoretically enable adaptive insulin dosing control, they face numerous challenges, including safety and training efficiency, which have hindered their clinical application. This paper proposes a safe and efficient adaptive insulin delivery controller based on DRL.
View Article and Find Full Text PDFJ Tissue Eng
January 2025
Department of Chemical Engineering, McGill University, Montreal, QC, Canada.
Islet transplantation and more recently stem cell-derived islets were shown to successfully re-establish glycemic control in people with type 1 diabetes under immunosuppression. These results were achieved through intraportal infusion which leads to early graft losses and limits the capacity to contain and retrieve implanted cells in case of adverse events. Extra-hepatic sites and encapsulation devices have been developed to address these challenges and potentially create an immunoprotective or immune-privileged environment.
View Article and Find Full Text PDFDiabetes Technol Ther
January 2025
Department of Diabetes and Endocrinology, University Hospitals of Derby and Burton NHS Foundation Trust, Royal Derby Hospital, Derby, United Kingdom.
To evaluate real-world outcomes in adults with type 1 diabetes initiating open-source automated insulin delivery systems (OS-AID). Adults with type 1 diabetes who commenced OS-AID, between May 2016 and April 2021, across 12 centers in the United Kingdom were included. Anonymized clinical data, collected during routine clinical care between December 2019 and November 2023, were submitted to a secure web-based tool within the National Health Service network.
View Article and Find Full Text PDFJ Diabetes Sci Technol
January 2025
Department of Endocrinology and Nephrology, Copenhagen University Hospital-North Zealand, Hillerød, Denmark.
Quant Imaging Med Surg
January 2025
Department of Intensive Care Unit, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Background: Acute pancreatitis (AP) is a potentially life-threatening condition characterized by inflammation of the pancreas, which can lead to complications such as pancreatic necrosis. The modified computed tomography severity index (MCTSI) is a widely used tool for assessing the severity of AP, particularly the extent of pancreatic necrosis. The accurate and timely assessment of the necrosis volume is crucial in guiding treatment decisions and improving patient outcomes.
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