This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor 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.
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