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利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 由于体力活动是糖尿病急性低血糖的主要触发因素，及时检测运动中和运动后的代谢变化对于成功进行闭环控制至关重要。然而，仅通过血糖监测不能可靠地检测到由于体力活动而增加的代谢需求。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。这项研究建议测试和验证：(I)使用连续血糖监测的闭环控制算法，向主治医生建议足够覆盖早餐并在早餐后使人稳定的胰岛素输注率；(Ii)心率监测和数据处理，使能够检测到血糖稳定期间的体力活动、其持续时间和强度；(Iii)体力活动引起的葡萄糖摄取和胰岛素敏感性变化的建模。这项拟议的研究有可能通过心率监测提供额外的信息源，从而克服闭环控制的主要局限性之一--无法解释由于体力活动引起的代谢变化。

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.