Strengths and Challenges of Closed-Loop Insulin Delivery During Exercise in People With Type 1 Diabetes: Potential Future Directions

Exercise has many physical and psychological benefits and is recommended for people with type 1 diabetes; however, there are many barriers to exercise, including glycemic instability and fear of hypoglycemia. Closed-loop (CL) systems have shown benefit in the overall glycemic management of type 1 di...

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Bibliographic Details
Published in:Journal of diabetes science and technology 2023-07, Vol.17 (4), p.1077-1084
Main Authors: Paldus, Barbora, Morrison, Dale, Lee, Melissa, Zaharieva, Dessi P., Riddell, Michael C., O’Neal, David N.
Format: Article
Language:English
Subjects:
Blood Glucose
Diabetes Mellitus, Type 1 - drug therapy
Humans
Hypoglycemia - chemically induced
Hypoglycemia - prevention & control
Insulin - therapeutic use
Insulin Infusion Systems
Insulin, Regular, Human - therapeutic use
Pancreas, Artificial
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Summary:Exercise has many physical and psychological benefits and is recommended for people with type 1 diabetes; however, there are many barriers to exercise, including glycemic instability and fear of hypoglycemia. Closed-loop (CL) systems have shown benefit in the overall glycemic management of type 1 diabetes, including improving HbA1c levels and reducing the incidence of nocturnal hypoglycemia; however, these systems are challenged by the rapidly changing insulin needs with exercise. This commentary focuses on the principles, strengths, and challenges of CL in the management of exercise, and discusses potential approaches, including the use of additional physiological signals, to address their shortcomings in the pursuit of fully automated CL systems.
ISSN:1932-2968
1932-2968
1932-3107
DOI:10.1177/19322968221088327