Closing the loop on exercise in type 1 diabetes.

Bally, Lia; Thabit, Hood (2018). Closing the loop on exercise in type 1 diabetes. Current diabetes reviews, 14(3), pp. 257-265. Bentham Science Publishers 10.2174/1573399813666170228121604

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Despite its well-established health benefits, exercise imposes challenges on glucose control in individuals with type 1 diabetes due to to the complex interactions between exercise-induced effects on glucose metabolism and exogenous insulin therapy. Although clinical guidelines for exercise management in type 1 diabetes are available, implementation is challenging in daily -life. The risk of exercise-induced dysglycaemia deters many people with type 1 diabetes from participating and benefiting from exercise. Rapid progress has been made in the development of closed-loop systems, also known as the artificial pancreas. The autonomous modulation of insulin delivery in a glucose-responsive manner by closed-loop systems may be beneficial in addressing and overcoming the risk and burden of exercise-induced dysglycaemia.


A summative overview of closed-loop application during exercise in type 1 diabetes is discussed, outlining current evidence and limitations, our perspectives in the field and future outlook.


Outcomes from clinical studies evaluating both single- and dual-hormone closed-loop during exercise are reported. Current approaches to enhance closed-loop performance during exercise are described.


Closed-loop system has the potential to ameliorate exercise management in type 1 diabetes. Promising results have been shown, however innovative approaches are still needed to overcome inherent limitations of closed-loop performance during exercise. Future studies in larger generalizable patient population during real-life settings are still needed, to further evaluate its clinical applicability.

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Bally, Lia Claudia


600 Technology > 610 Medicine & health




Bentham Science Publishers




Andreas Melmer

Date Deposited:

25 Feb 2019 17:20

Last Modified:

05 Dec 2022 15:10

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

artificial pancreas closed-loop exercise glucagon glucose control hypoglycaemia insulin type 1 diabetes


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