Glycemic control during and after exercise is challenging. APs reduce %<70 and TIR, but do not eliminate exercise-induced hypoglycemia. Recent work has shown that insulin reduction 90min prior to exercise may be optimal. We present the initial testing of an exercise-informed AP, able to anticipate regular exercise by up to 2h without user input. Eighteen adults with T1D were enrolled in a randomized crossover trial: 4-weeks data collection (DC: SAP+step counter) followed by two 32h supervised hotel stays (SH). During DC, participants were asked to exercise 4 times/week for >30min, between 4-7pm. During SH, participants used either a naïve AP (CTL) or exercise informed AP (EX) and participated in 45min of moderate exercise at 17:30 on day 1. Fifteen subjects completed the study, age 42.2±13.6, HbA1c 6.61±1.02, with no system related AEs. During exercise, EX and CTL had similar TIR 88.2 vs. 85.2%, with a tendency to less time <80mgdL, 14.8 vs. 8.2%, following a reduction of insulin from 2.4 to 1.8 U over the preceding 2h. Post exercise EX and CTL had similar TIR (87.2 vs. 85.5%) but EX had less %<70 1.1% vs. 8.9% p=0.04,overnight control was excellent in both case TIR: 98.1 vs. 99.4%; %<70: 0.1 vs. 0.6%. During the sedentary late afternoon (5-7pm day 2) there was no difference in TIR: 89.6 vs. 86.0%. APs can learn from prior exercise behaviors and anticipate them, potentially leading to reduced glycemic risk, and a more automated system.
J. Garcia-Tirado: None. S.A. Brown: Research Support; Self; Dexcom, Inc., Insulet Corporation, Roche Diabetes Care, Tandem Diabetes Care, Tolerion, Inc. N. Laichuthai: None. H.E. Myers: None. M.D. Breton: Research Support; Self; Dexcom, Inc., Novo Nordisk A/S, Sanofi, Tandem Diabetes Care. Speaker’s Bureau; Self; Dexcom, Inc., Tandem Diabetes Care.
National Institutes of Health (DP3DK106826)