# Modeling the Effect of Athletic Competition Anxiety on Blood Glucose Dynamics in Type 1 Diabetes

> **NIH NIH F31** · ILLINOIS INSTITUTE OF TECHNOLOGY · 2020 · $41,640

## Abstract

Exercise is a challenge for people with type 1 diabetes (T1D) because different activity types and intensities
have different impacts on glucose concentrations. This challenge is amplified on competition days, as the added
stress and high-intensity activity causes drastically different glucose responses than during exercise on non-
competition days. This can occur due to a combination of increased hepatic glycogenolysis anaerobic exercise
and the counterregulatory hormone response associated with the stress of competition. Thus, many people with
T1D limit their physical activity due to fear of hypoglycemia during or after the activity and the majority of people
with T1D do not engage in enough physical activity with less than 20% performing aerobic exercise more than
twice per week. Regardless of the desire to exercise, people with T1D may be caught in scenarios where they
are doing physical activity such running to catch a bus to commute to work may cause a spike in blood glucose
concentration due to the anaerobic nature of the sprint and the added stress of arriving late if he or she were to
miss the bus. One would not have had time to consider the appropriate insulin dose to prevent hyperglycemia
and would benefit greatly from a system that would monitor these states and make corrections without requiring
user input. Artificial pancreas (AP) systems will simplify the treatment of T1D and more advanced research is
needed to increase their efficacy during and after exercise.
The AP automates the computation of the proper insulin dose by using a continuous subcutaneous glucose
sensor (CGM), an automatic control system, and an insulin pump that continuously infuses insulin into the
subcutaneous tissue. The limitation of this configuration is its reliance on a single measurement, the glucose
concentration, which varies in response to changes in many factors such as meals and exercise. The Cinar
group at Illinois Institute of Technology pioneered the multivariable AP development. Signals streamed in real
time from wearable devices complement glucose data to build accurate models to predict future variations in
glucose levels. These models are updated recursively with each new set of measurements and used in
hypoglycemia prediction and adaptive control. A new generation multivariable AP system that will incorporate
the presence of competition stress with knowledge of physical activity type and intensity with well-developed
machine learning algorithms for data interpretation in real-time, hypoglycemia early-warning systems, and
automatic control will be more effective in improving glucose control in physically-active people with T1D.
Additionally, this technology will be safer by dramatically reducing the number and duration of hypoglycemic and
hyperglycemic events, as compared to the current guidelines for maintaining euglycemia in exercise. Such AP
systems can only be developed by using a sophisticated multivariable approach that includes glucose
co...

## Key facts

- **NIH application ID:** 9994897
- **Project number:** 5F31DK116524-03
- **Recipient organization:** ILLINOIS INSTITUTE OF TECHNOLOGY
- **Principal Investigator:** Nicole Hobbs
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $41,640
- **Award type:** 5
- **Project period:** 2018-09-01 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9994897

## Citation

> US National Institutes of Health, RePORTER application 9994897, Modeling the Effect of Athletic Competition Anxiety on Blood Glucose Dynamics in Type 1 Diabetes (5F31DK116524-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9994897. Licensed CC0.

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