ASSESMENT OF INSULIN SENSITIVITY DURING EXERCISE IN TYPE 1 DIABETES MELLITUS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 由于体力活动是糖尿病急性低血糖的主要触发因素，因此及时检测运动期间和运动后的代谢变化对于闭环控制的成功至关重要。然而，由于身体活动而增加的代谢需求不能单独通过葡萄糖监测可靠地检测。我们的想法是利用心率的变化作为代谢需求增加的相关性。 本研究旨在测试和验证：（i）闭环控制算法，该算法使用连续葡萄糖监测向主治医生建议胰岛素输注速率，该速率将足以覆盖早餐并在早餐后稳定患者;（ii）心率监测和数据处理，该算法将能够检测血糖稳定期间的体力活动、其持续时间和强度;（iii）对由于身体活动引起的葡萄糖摄取和胰岛素敏感性的变化进行建模。拟议的研究有可能克服闭环控制的主要限制之一-无法解释由于身体活动引起的代谢变化-通过心率监测提供额外的信息源。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Because physical activity is a major trigger of acute hypoglycemia in diabetes, the timely detection of metabolic changes during and after exercise is critical for the success of closed-loop control. However, increased metabolic demand due to physical activity cannot be reliably detected via glucose monitoring alone. Our idea is to use changes in heart rate as a correlate to increased metabolic demand. This study proposes to test and validate: (i) a closed-loop control algorithm that uses continuous glucose monitoring to suggest to the attending physician insulin infusion rate that will adequately cover a breakfast and will stabilize the person after that; (ii) heart rate monitoring and data processing that will enable the detection of physical activity, its duration and intensity during the period of glycemic stability; (iii) the modeling of changes in glucose uptake and insulin sensitivity due to physical activity. The proposed study has the potential to overcome one of the major limitations of closed-loop control - the inability to account for metabolic changes due to physical activity - by providing an additional information source through heart rate monitoring.