BACKGROUND: In type 1 diabetes mellitus (T1DM), physical activity (PA) lowers the risk of cardiovascular complications but hinders the achievement of optimal glycemic control, transiently boosting insulin action and increasing hypoglycemia risk. Quantitative investigation of relationships between PA-related signals and glucose dynamics, tracked using, for example, continuous glucose monitoring (CGM) sensors, have been barely explored. SUBJECTS AND METHODS: In the clinic, 20 control and 19 T1DM subjects were studied for 4 consecutive days. They underwent low-intensity PA sessions daily. PA was tracked by the PA monitoring system (PAMS), a system comprising accelerometers and inclinometers. Variations on glucose dynamics were tracked estimating first- and second-order time derivatives of glucose concentration from CGM via Bayesian smoothing. Short-time effects of PA on glucose dynamics were quantified through the partial correlation function in the interval (0, 60 min) after starting PA. RESULTS: Correlation of PA with glucose time derivatives is evident. In T1DM, the negative correlation with the first-order glucose time derivative is maximal (absolute value) after 15 min of PA, whereas the positive correlation is maximal after 40-45 min. The negative correlation between the second-order time derivative and PA is maximal after 5 min, whereas the positive correlation is maximal after 35-40 min. Control subjects provided similar results but with positive and negative correlation peaks anticipated of 5 min. CONCLUSIONS: Quantitative information on correlation between mild PA and short-term glucose dynamics was obtained. This represents a preliminary important step toward incorporation of PA information in more realistic physiological models of the glucose-insulin system usable in T1DM simulators, in development of closed-loop artificial pancreas control algorithms, and in CGM-based prediction algorithms for generation of hypoglycemic alerts.
BACKGROUND: In type 1 diabetes mellitus (T1DM), physical activity (PA) lowers the risk of cardiovascular complications but hinders the achievement of optimal glycemic control, transiently boosting insulin action and increasing hypoglycemia risk. Quantitative investigation of relationships between PA-related signals and glucose dynamics, tracked using, for example, continuous glucose monitoring (CGM) sensors, have been barely explored. SUBJECTS AND METHODS: In the clinic, 20 control and 19 T1DM subjects were studied for 4 consecutive days. They underwent low-intensity PA sessions daily. PA was tracked by the PA monitoring system (PAMS), a system comprising accelerometers and inclinometers. Variations on glucose dynamics were tracked estimating first- and second-order time derivatives of glucose concentration from CGM via Bayesian smoothing. Short-time effects of PA on glucose dynamics were quantified through the partial correlation function in the interval (0, 60 min) after starting PA. RESULTS: Correlation of PA with glucose time derivatives is evident. In T1DM, the negative correlation with the first-order glucose time derivative is maximal (absolute value) after 15 min of PA, whereas the positive correlation is maximal after 40-45 min. The negative correlation between the second-order time derivative and PA is maximal after 5 min, whereas the positive correlation is maximal after 35-40 min. Control subjects provided similar results but with positive and negative correlation peaks anticipated of 5 min. CONCLUSIONS: Quantitative information on correlation between mild PA and short-term glucose dynamics was obtained. This represents a preliminary important step toward incorporation of PA information in more realistic physiological models of the glucose-insulin system usable in T1DM simulators, in development of closed-loop artificial pancreas control algorithms, and in CGM-based prediction algorithms for generation of hypoglycemic alerts.
Authors: Chiara Zecchin; Andrea Facchinetti; Giovanni Sparacino; Giuseppe De Nicolao; Claudio Cobelli Journal: IEEE Trans Biomed Eng Date: 2012-02-24 Impact factor: 4.538
Authors: Scott M Pappada; Brent D Cameron; Paul M Rosman; Raymond E Bourey; Thomas J Papadimos; William Olorunto; Marilyn J Borst Journal: Diabetes Technol Ther Date: 2011-02 Impact factor: 6.118
Authors: Marc Breton; Anne Farret; Daniela Bruttomesso; Stacey Anderson; Lalo Magni; Stephen Patek; Chiara Dalla Man; Jerome Place; Susan Demartini; Simone Del Favero; Chiara Toffanin; Colleen Hughes-Karvetski; Eyal Dassau; Howard Zisser; Francis J Doyle; Giuseppe De Nicolao; Angelo Avogaro; Claudio Cobelli; Eric Renard; Boris Kovatchev Journal: Diabetes Date: 2012-06-11 Impact factor: 9.461
Authors: S D Patek; L Magni; E Dassau; C Karvetski; C Toffanin; G De Nicolao; S Del Favero; M Breton; C Dalla Man; E Renard; H Zisser; F J Doyle; C Cobelli; B P Kovatchev Journal: IEEE Trans Biomed Eng Date: 2012-04-03 Impact factor: 4.538
Authors: William V Tamborlane; Roy W Beck; Bruce W Bode; Bruce Buckingham; H Peter Chase; Robert Clemons; Rosanna Fiallo-Scharer; Larry A Fox; Lisa K Gilliam; Irl B Hirsch; Elbert S Huang; Craig Kollman; Aaron J Kowalski; Lori Laffel; Jean M Lawrence; Joyce Lee; Nelly Mauras; Michael O'Grady; Katrina J Ruedy; Michael Tansey; Eva Tsalikian; Stuart Weinzimer; Darrell M Wilson; Howard Wolpert; Tim Wysocki; Dongyuan Xing Journal: N Engl J Med Date: 2008-09-08 Impact factor: 91.245
Authors: Eyal Dassau; Howard Zisser; Rebecca A Harvey; Matthew W Percival; Benyamin Grosman; Wendy Bevier; Eran Atlas; Shahar Miller; Revital Nimri; Lois Jovanovic; Francis J Doyle Journal: Diabetes Care Date: 2012-11-27 Impact factor: 19.112