While the benefits of regular physical activity are well established for individuals with type 1 diabetes, glucose control remains a challenge with conventional therapeutic tools during and after physical activity. Factors affecting glucose fluctuations include activity type (aerobic, anaerobic or mixed), intensity and duration of the activity, level of hydration, the secretion of counter-regulatory hormones as well as the amount of insulin and nutrients in the body when the physical activity is performed.
Closed-loop glycemic control (or artificial pancreas), characterized by glucose-responsive automated insulin delivery is now a routine clinical reality for many individuals living with type 1 diabetes. To date, there are two approved single-hormone closed-loop systems available: Minimed 670G (Medtronic, USA) and more recently Control-IQ (Tandem Diabetes Care, USA), while there are several other devices extensively evaluated at home, mainly unsupervised, and for longer periods. The performance of closed-loop glycemic control in individuals with type 1 diabetes during and after the physical activity has been extensively evaluated, including single and dual hormone glucose control, different clinical settings and exercise modalities, various age groups, and adding additional signals to detect physical activity, such as activity and heart rate monitoring.
In this presentation, we will present current data on closed-loop glycemic control challenged by physical activity.