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No more hypoglycaemia on days with physical activity and unrestricted diet when using a closed-loop system for

Sylvia Franc1,2,3, Pierre-Yves Benhamou4, Sophie Borot5

  • 1Department of Diabetes, Sud-Francilien Hospital, Corbeil-Essonnes, France.

Diabetes, Obesity & Metabolism
|May 19, 2021
PubMed

Insights

The Diabeloop Generation-1 (DBLG1) system effectively prevents hypoglycemia during physical activity (PA) in type 1 diabetes patients. It achieves this by adjusting insulin and recommending carbohydrates, maintaining glucose control despite exercise.

Area of Science:

  • Endocrinology
  • Diabetes Technology

Background:

  • Physical activity (PA) poses a risk of hypoglycemia for type 1 diabetes (T1D) patients.
  • Closed-loop systems aim to mitigate exercise-induced glycemic variability.

Purpose of the Study:

  • To evaluate the efficacy of the Diabeloop Generation-1 (DBLG1) closed-loop system in preventing PA-induced hypoglycemia.
  • To analyze glycemic outcomes during PA in real-life conditions.

Main Methods:

  • Post hoc analysis of the Diabeloop WP7 randomized controlled trial.
  • Comparison of glycemic outcomes between days with and without PA in 56 T1D patients using DBLG1 for 12 weeks.
  • Monitoring of time in hypoglycemia, insulin delivery, and carbohydrate intake.

Main Results:

  • No significant difference in time spent below 70 mg/dL between days with and without PA (2.0% vs. 2.2%).
  • Significantly higher recommended carbohydrate intake (41.1g vs. 21.8g) and lower insulin delivery (31.5U vs. 34.0U) on PA days.
  • Increased time in hyperglycemia and glycemic variation coefficient observed on PA days.

Conclusions:

  • The DBLG1 system effectively prevents hypoglycemia during physical activity in T1D patients under real-world conditions.
  • Insulin reduction and carbohydrate recommendations are key mechanisms for this benefit.
  • While hypoglycemia is avoided, hyperglycemia and glycemic variability may increase during PA.

Keywords:
artificial pancreasclosed-loop systemcontinuous glucose monitoringglycaemic controlhypoglycaemiainsulin pump therapyphysical activityphysical interventionrandomized controlled trialtype 1 diabetes

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