title: Exercise and the Development of the Artificial Pancreas: One of the More Difficult Series of Hurdles.
abstract: Regular physical activity (PA) promotes numerous health benefits for people living with type 1 diabetes (T1D). However, PA also complicates blood glucose control. Factors affecting blood glucose fluctuations during PA include activity type, intensity and duration as well as the amount of insulin and food in the body at the time of the activity. To maintain equilibrium with blood glucose concentrations during PA, the rate of glucose appearance (Ra) to disappearance (Rd) in the bloodstream must be balanced. In nondiabetics, there is a rise in glucagon and a reduction in insulin release at the onset of mild to moderate aerobic PA. During intense aerobic -anaerobic work, insulin release first decreases and then rises rapidly in early recovery to offset a more dramatic increase in counterregulatory hormones and metabolites. An "exercise smart" artificial pancreas (AP) must be capable of sensing glucose and perhaps other physiological responses to various types and intensities of PA. The emergence of this new technology may benefit active persons with T1D who are prone to hypo and hyperglycemia.
authors.affiliation: School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada mriddell@yorku.ca.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Riddell
authors.affiliation: School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada.
authors.forename: Dessi P
authors.initials: DP
authors.lastname: Zaharieva
authors.affiliation: School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada.
authors.forename: Loren
authors.initials: L
authors.lastname: Yavelberg
authors.affiliation: Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA Department of Chemical and Biological Engineering, Illinois Institute of Technology, Chicago, IL, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Cinar
authors.affiliation: School of Kinesiology and Health Science, Faculty of Health, Physical Activity and Chronic Disease Unit, York University, Toronto, Ontario, Canada.
authors.forename: Veronica K
authors.initials: VK
authors.lastname: Jamnik
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000465:Algorithms; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004059:Diffusion of Innovation; D004734:Energy Metabolism / Q000187:drug effects; D004867:Equipment Design; D015444:Exercise; D005934:Glucagon / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D009043:Motor Activity; D019397:Pancreas, Artificial; D011237:Predictive Value of Tests; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D005934:Glucagon
keywords: artificial pancreas; exercise; insulin; metabolism