Diabetes mellitus affects approximately 460 million people worldwide, of which type 1 diabetes is estimated to impact 1.1 million children and adolescents under the age of 20 worldwide. Hypoglycemia (too low blood glucose levels) is among the most relevant acute complications of type 1 diabetes, that may lead to acute seizures, loss of consciousness, coma or even death. Almost 50% of all episodes of severe hypoglycemia occur at night, potentially resulting in sudden death (dead-in-bed syndrome).

As for any individual, regular physical exercise is essential for health, fitness and longevity, and is associated with many well-established health benefits for individuals with type 1 diabetes. However, physical exercise can be especially challenging, as blood glucose levels are influenced by a complex interplay of various factors, and there exists an increased risk of nocturnal hypoglycemia after exercise. Therefore, individuals with type 1 diabetes who wish to engage in sports are required to skillfully balance insulin dosing and food intake, before, during and after exercise. This may be a huge obstacle for engaging in physical activity, and may reduce the quality of life.

We aim to develop a warning system (HYPEX) for (1) dysglycemia during exercise, and (2) hypoglycemia in the nocturnal period after exercise, based on historical glucose data (from Continuous Glucose Monitoring, CGM), and data of past and planned exercise. This should prevent hypoglycemia and improve quality of life for individuals with type 1 diabetes.

HYPEX is a collaboration of the Inselspital Bern (Department of Diabetes, Endocrinology, Clinical Nutrition and Metabolism), the Bosch IoT Lab and Center for Digital Health Interventions (CDHI) at ETH Zurich and the University of St. Gallen, and Team Novo Nordisk, the first professional cycling team consisting solely of athletes with type 1 diabetes.

Photo credits: Team Novo Nordisk