Evidence map›Paper›PMID 24702135›Full record

Trial reportDiabetes technology & therapeutics2014

Adding heart rate signal to a control-to-range artificial pancreas system improves the protection against hypoglycemia during exercise in type 1 diabetes.

Marc D Breton, Sue A Brown, Colleen Hughes Karvetski, Laura Kollar, Katarina A Topchyan, Stacey M Anderson, Boris P Kovatchev

3 registry-linked trialsOpen access · greenAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Diabetes technology & therapeutics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 66 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 1 pooled it
9.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01582139 nacompletednot on this map

Feasibility Study of Closed Loop Control in Type 1 Diabetes Using Heart Rate Monitoring as an Exercise Marker

TypeinterventionalSponsorUniversity of VirginiaRan2012 to 2012Enrolled12ConditionsType 1 Diabetes MellitusArmsHeart rate informed SSM+HMM
NCT03090451 nacompletednot on this mapstarted 2017, after this paper: background citation

Evaluating the Dynamics of Insulin and Non-insulin Mediated Effects on Glucose During Aerobic Exercise in Subjects With Type 1 Diabetes

TypeinterventionalSponsorOregon Health and Science UniversityRan2017 to 2019Enrolled26ConditionsType 1 Diabetes Mellitus, HypoglycemiaArmsAerobic Exercise
NCT05736263 naunknown statusnot on this mapstarted 2023, after this paper: background citation

Setting a New Algorithm For the Management of Exercise-induced Glycemic Variations in Patients With Type 1 Diabetes in Intensive Therapy With Hybrid Closed-loop Systems

TypeinterventionalSponsorUniversity of Roma La SapienzaRan2023 to 2024Enrolled50ConditionsType 1 Diabetes, ExerciseArmsModerate intensity exercise, High intensity interval exercise, Combined exercise, Resistance exercise
3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 1 synthesis or guideline pooled it, 131 citations in OpenAlex.

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  13. Metabolic Models, in Silico Trials, and Algorithms.Diabetes technology & therapeutics · 2025
    Review
  14. Metabolic Models, in Silico Trials, and Algorithms.Journal of diabetes science and technology · 2025
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6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Marc D BretonCenter for Diabetes Technology, University of Virginia , Charlottesville, Virginia.
Sue A Brown
Colleen Hughes Karvetski
Laura Kollar
Katarina A Topchyan
Stacey M Anderson
Boris P Kovatchev
University of Virginia · US

Funding

Introduction of Heart Rate Monitoring to the Closed-Loop Control of T1DMR21DK085641 · NIDDK · UNIVERSITY OF VIRGINIA · PI BRETON, MARC D · 2009 to 2010
$421k
NIDDK NIH HHS R21DK085641
6 · The paper itself

Abstract

backgroundWe present a clinical trial establishing the feasibility of a control-to-range (CTR) closed-loop system informed by heart rate (HR) and assess the effect of HR information added to CTR on the risk for hypoglycemia during and after exercise. SUBJECTS AND

methodsTwelve subjects with type 1 diabetes (five men, seven women; weight, 68.9 ± 3.1 kg; age, 38 ± 3.3 years; glycated hemoglobin, 6.9 ± 0.2%) participated in a randomized crossover clinical trial comparing CTR versus CTR+HR in two 26-h admissions, each including 30 min of mild exercise. The CTR algorithm was implemented in the DiAs portable artificial pancreas platform based on an Android(®) (Google, Mountainview, CA) smartphone. We assessed blood glucose (BG) decline during exercise, the Low BG Index (LBGI) (a measure of hypoglycemic risk), number of hypoglycemic episodes (BG <70 mg/dL) and overall glucose control (percentage time within the target range 70 mg/dL ≤ BG ≤ 180 mg/dL).

resultsUsing HR to inform the CTR algorithm reduced significantly the BG decline during exercise (P=0.022), indicated marginally lower LBGI (P=0.3) and fewer hypoglycemic events during exercise (none vs. two events; P=0.16), and resulted in overall higher percentage time within the target range (81% vs. 75%; P=0.2). LBGI and average BG remained unchanged overall, during recovery, and overnight.

conclusionsHR-informed closed-loop control can be implemented in a portable artificial pancreas. Although closed loop has been shown to reduce hypoglycemia, adding HR signal may further limit the risk for hypoglycemia during and immediately after exercise. The most prominent effect of adding HR information is reduced BG decline during exercise, without deterioration of overall glycemic control.

Indexed as

Heart RateMonitoring, PhysiologicPancreas, ArtificialAdultAlgorithmsBlood GlucoseCross-Over StudiesDiabetes Mellitus, Type 1ExerciseFeasibility StudiesFemaleGlycated HemoglobinHumansHypoglycemiaHypoglycemic AgentsMaleBlood GlucoseGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agents

Identifiers

PMID24702135
PMCPMC4116126
OpenAlexW2333815048

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.