Use and outcome of hybrid-closed loop Automated Insulin Delivery systems in real-world sporting events: an exploratory observational study

Physical activity is important for optimal health, but is difficult to manage for many people with type 1 diabetes due to glucose management challenges. Recent hybrid-closed loop Automated Insulin Delivery (AID) systems are better able to compensate for glucose levels after physical activity, but have limited pre/peri adaptation possibilities. Little is known about the most optimal way of how to deal with physical activity in real-life settings with these systems.

 

A study was set up with the aims to:

 

• determine how closed-loop systems and their users (adults with typ1 diabetes) handle glucose management in intermediate and intensive physical activity situations
• examine the impact on medical and person-reported outcomes(PROs)
• determine the (mis)fit with regular care physical activity advice
• distill recommendations for an adapted protocol.

This exploratory longitudinal mixed-method case-control observational study will follow 10 adults with type 1 diabetes using a closed-loop system as part of their regular diabetes care shortly before and during a six-day real-world intermediate/intensive physical activity situation (enrolled for the We Bike 2 Change Diabetes Extremadura fundraising cycling challenge in the Extremadura region in Spain). Comparisons (mostly descriptive) are made with people with type 1 diabetes using open loop (n≈6), as well as people without diabetes (n≈4).

 

Main study parameters/endpoints comprise actions related to glucose management before, during and after intermediate and intensive physical activity.