HYPOGLYCEMIA PREVENTION AFTER EXERCISE IN ADOLESCENT T1DM

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 随着人工胰腺系统在医院环境中并最终在现场条件下进行测试，很明显，这种系统在低血糖症和高血糖症中都会遭受大量的葡萄糖波动。对防止这种大的葡萄糖变化的监督系统的需求是由于现代控制器不能适当地适应和反应非常高和/或非常低的葡萄糖以及所产生的定性代谢变化（例如，反调节和葡萄糖毒性）。这种被称为范围控制器的监督系统的目的不是完美的葡萄糖控制（即，与健康相当的葡萄糖变化），而是减轻大的葡萄糖偏差，保持患者安全并为更精确的控制策略创造环境以最佳地发挥作用。该方案旨在证明在不同代谢条件下（如进餐、轻度运动和睡眠），在GCRC环境中使用这种监测系统的可行性。我们的系统基于连续监测和皮下胰岛素注射，并监测患者的常规治疗，即除非检测到治疗错误（葡萄糖变低或变高），否则系统将保持不活动状态。将使用低血糖事件的频率和在较宽血糖目标范围内花费的时间量来评估系统的性能。

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. As artificial pancreas systems are tested in hospital settings and eventually in field conditions, it becomes apparent that such systems suffer from ample glucose excursions, both in hypoglycemia and hyperglycemia. The need for supervisory systems that prevent such large glucose variation rise from the incapacity of modern controllers to properly adapt and react to very high and/or very low glucose, and the resulting qualitative metabolic changes (e.g. counter-regulation and gluco-toxicity). Such supervisory systems, called controllers to range, are not aiming at perfect glucose control (i.e. glucose variations comparable to health) but at mitigating large glucose deviations, keeping the patient safe and create the environment for more precise control strategies to function optimally. This protocol is designed to demonstrate the feasibility in a GCRC setting of such a supervisory system during different metabolic conditions, such as meals, mild exercise and sleep. Our system is based on continuous monitoring and subcutaneous insulin injections, and monitors the patient's regular treatment, i.e. unless an error in treatment is detected (glucose going low or high) the system will stay inactive. Performances of the system will be assessed using frequency of hypoglycemic events and amount of time spent in a wide glucose target range.