Incorporating an Exercise Detection, Grading, and Hormone Dosing Algorithm Into the Artificial Pancreas Using Accelerometry and Heart Rate

Jacobs, Peter G.; Resalat, Navid; El Youssef, Joseph; Reddy, Ravi; Branigan, Deborah; Preiser, Nicholas; Condon, John; Castle, Jessica

doi:10.1177/1932296815609371

Cited by 105Diabetes Management and ResearchContext-Aware Activity Recognition SystemsDiabetes Management and Education

Incorporating an Exercise Detection, Grading, and Hormone Dosing Algorithm Into the Artificial Pancreas Using Accelerometry and Heart Rate

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Jacobs, Peter G., Resalat, Navid, El Youssef, Joseph, Reddy, Ravi, Branigan, Deborah, Preiser, Nicholas, Condon, John, Castle, Jessica·2015·Journal of Diabetes Science and Technology

DOI 10.1177/1932296815609371PMC PMC4667295

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Abstract

In this article, we present several important contributions necessary for enabling an artificial endocrine pancreas (AP) system to better respond to exercise events. First, we show how exercise can be automatically detected using body-worn accelerometer and heart rate sensors. During a 22 hour overnight inpatient study, 13 subjects with type 1 diabetes wearing a Zephyr accelerometer and heart rate monitor underwent 45 minutes of mild aerobic treadmill exercise while controlling their glucose levels using sensor-augmented pump therapy. We used the accelerometer and heart rate as inputs into a validated regression model. Using this model, we were able to detect the exercise event with a sensitivity of 97.2% and a specificity of 99.5%. Second, from this same study, we show how patients’ glucose declined during the exercise event and we present results from in silico modeling that demonstrate how including an exercise model in the glucoregulatory model improves the estimation of the drop in glucose during exercise. Last, we present an exercise dosing adjustment algorithm and describe parameter tuning and performance using an in silico glucoregulatory model during an exercise event.

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Activity monitors can be used in conjunction with on-body continuous glucose monitors, an insulin pump and a control algorithm to adjust insulin delivery, and perhaps glucagon delivery in real time.
“In theory, activity monitors can be used in conjunction with on-body continuous glucose monitors, an insulin pump and a control algorithm to adjust insulin delivery, and perhaps glucagon delivery in real time [5,6].”
From Accuracy of Wrist-Worn Activity Monitors During Common Daily Physical Activities and Types of Structured Exercise: Evaluation Study (2018) · cites this paper as [6]
The glucagon dynamics model was previously described by Jacobs et al. [14].
“The glucagon dynamics model which describes the interaction between the plasma glucagon concentration and the EGP was previously described by Jacobs et al. [14]”
From A statistical virtual patient population for the glucoregulatory system in type 1 diabetes with integrated exercise model (2019) · cites this paper as Jacobs et al. [14]
The glucose kinetics model was presented in Hovorka et al. [11] and Jacobs et al. [14].
“The glucose kinetics model, which estimates blood glucose with respect to insulin and glucagon actions and non-insulin mediated glucose uptake, was presented in Hovorka et al. [11] and Jacobs et al. [14]”
From A statistical virtual patient population for the glucoregulatory system in type 1 diabetes with integrated exercise model (2019) · cites this paper as Jacobs et al. [14]
Previously, the authors showed how an exercise model described by Hernandez-Ordonez et al. [17] could be incorporated into a VPP.
“Previously, we showed how an exercise model described by Hernandez-Ordonez et al. [17] could be incorporated into a VPP [14, 18, 19].”
From A statistical virtual patient population for the glucoregulatory system in type 1 diabetes with integrated exercise model (2019) · cites this paper as [14]

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Authors: Jacobs, P. G., Resalat, N., El Youssef, J., Reddy, R., Branigan, D., Preiser, N., Condon, J., & Castle, J.
Affiliations: Oregon Health & Science University (US)
Harold Schnitzer Diabetes Health Center, Oregon Health and Science University, Portland OR, USA
Corresponding author: Jacobs, Peter G.
ORCID: Jacobs, Peter G.
Resalat, Navid
Reddy, Ravi
Branigan, Deborah
Castle, Jessica
Venue: Journal of Diabetes Science and Technology
Publisher: SAGE Publications
Published: 2015-10-05
Volume: 9
Issue: 6
Pages: 1175-1184
ISSN: 1932-2968 (ISSN-L)
DOI: 10.1177/1932296815609371
PMC: PMC4667295
OpenAlex: W2237750930
Cited by: 105
References: 29
Citations by year: 2026: 1 · 2025: 10 · 2024: 8 · 2023: 14 · 2022: 8 · 2021: 8 · 2020: 12 · 2019: 22 · 2018: 4 · 2017: 9 · 2016: 9
FWCI: 6.38
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Journal of Diabetes Science and Technology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (UL1TR000128, 5k23dk090133-03)
National Institute of Diabetes and Digestive and Kidney Diseases (K23-DK-090133, DP3DK101044)
National Center for Research Resources (UL1RR024140)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: artificial pancreas, type 1 diabetes, exercise detection, accelerometer, heart rate monitoring, sensor-augmented pump therapy, in silico modeling
MeSH terms: Algorithms, Blood Glucose, Computer Simulation, Diabetes Mellitus, Type 1, Energy Metabolism, Equipment Design, Exercise Test, Glucagon, Heart Rate, Humans, Hypoglycemic Agents, Insulin, Models, Biological, Predictive Value of Tests, Time Factors, Biomarkers, Exercise, Linear Models, Pancreas, Artificial, Drug Dosage Calculations, Actigraphy

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Incorporating an Exercise Detection, Grading, and Hormone Dosing Algorithm Into the Artificial Pancreas Using Accelerometry and Heart Rate

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