Closing the Loop on Exercise in Type 1 Diabetes.
Journal article

Closing the Loop on Exercise in Type 1 Diabetes.

  • Bally L Department of Diabetes, Endocrinology, Clinical Nutrition & Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland.
  • Thabit H Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom.
  • 2017-03-02
Published in:
  • Current diabetes reviews. - 2018
English BACKGROUND
Despite its well-established health benefits, exercise imposes challenges on glucose control in individuals with type 1 diabetes due to the complex interactions between exerciseinduced 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 benefitting 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 glucoseresponsive 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.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/185136
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