{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:07:28Z","timestamp":1791630448327,"version":"4.3.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Exercise is known to increase the risk for hypoglycemia in type 1 diabetes (T1D) but predicting when it may occur remains a major challenge. The objective of this study was to develop a hypoglycemia prediction model based on a large real-world study of exercise in T1D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Design and Methods:<\/jats:title>\n                    <jats:p>Structured study-specified exercise (aerobic, interval, and resistance training videos) and free-living exercise sessions from the T1D Exercise Initiative study were used to build a model for predicting hypoglycemia, a continuous glucose monitoring value &lt;70\u2009mg\/dL, during exercise. Repeated measures random forest (RMRF) and repeated measures logistic regression (RMLR) models were constructed to predict hypoglycemia using predictors at the start of exercise and baseline characteristics. Models were evaluated with area under the receiver operating characteristic curve (AUC) and balanced accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>RMRF and RMLR had similar AUC (0.833 vs. 0.825, respectively) and both models had a balanced accuracy of 77%. The probability of hypoglycemia was higher for exercise sessions with lower pre-exercise glucose levels, negative pre-exercise glucose rates of change, greater percent time &lt;70\u2009mg\/dL in the 24\u2009h before exercise, and greater pre-exercise bolus insulin-on-board (IOB). Free-living aerobic exercises, walking\/hiking, and physical labor had the highest probability of hypoglycemia, while structured exercises had the lowest probability of hypoglycemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>RMRF and RMLR accurately predict hypoglycemia during exercise and identify factors that increase the risk of hypoglycemia. Lower glucose, decreasing levels of glucose before exercise, and greater pre-exercise IOB largely predict hypoglycemia risk in adults with T1D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/dia.2023.0140","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T11:13:56Z","timestamp":1686309236000},"page":"602-611","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["The Type 1 Diabetes and EXercise Initiative: Predicting Hypoglycemia Risk During Exercise for Participants with Type 1 Diabetes Using Repeated Measures Random Forest"],"prefix":"10.1177","volume":"25","author":[{"given":"Simon","family":"Bergford","sequence":"first","affiliation":[{"name":"JAEB Center for Health Research, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6556-7559","authenticated-orcid":false,"given":"Michael C.","family":"Riddell","sequence":"additional","affiliation":[{"name":"Muscle Health Research Centre, York University, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Artificial Intelligence for Medical Systems Lab, Department of Biomedical Engineering, Oregon Health and Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5950-9317","authenticated-orcid":false,"given":"Zoey","family":"Li","sequence":"additional","affiliation":[{"name":"JAEB Center for Health Research, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin L.","family":"Gal","sequence":"additional","affiliation":[{"name":"JAEB Center for Health Research, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Clements","sequence":"additional","affiliation":[{"name":"Children's Mercy Hospital, Kansas City, Missouri, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3293-9114","authenticated-orcid":false,"given":"Francis J.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corby K.","family":"Martin","sequence":"additional","affiliation":[{"name":"Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8902-6965","authenticated-orcid":false,"given":"Susana R.","family":"Patton","sequence":"additional","affiliation":[{"name":"Nemours Children's Health, Jacksonville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1179-5374","authenticated-orcid":false,"given":"Jessica R.","family":"Castle","sequence":"additional","affiliation":[{"name":"Harold Schnitzer Diabetes Health Center, Oregon Health and Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0897-8268","authenticated-orcid":false,"given":"Melanie B.","family":"Gillingham","sequence":"additional","affiliation":[{"name":"Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5194-8446","authenticated-orcid":false,"given":"Roy W.","family":"Beck","sequence":"additional","affiliation":[{"name":"JAEB Center for Health Research, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9253-838X","authenticated-orcid":false,"given":"Michael R.","family":"Rickels","sequence":"additional","affiliation":[{"name":"Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5325-7200","authenticated-orcid":false,"given":"Peter","family":"Calhoun","sequence":"additional","affiliation":[{"name":"JAEB Center for Health Research, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the T1DEXI Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-022-00756-6"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2015.12.001"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0720"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2018.05.020"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0108019"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2022.02.009"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2013.0333"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296815592409"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296815609371"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296815609369"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296814524862"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2022.103888"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0228"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2267"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1021\/ie3034015"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296818823792"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-1721"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2020.0357"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05263-9"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/biom.13284"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1023\/A:1010933404324"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30014-1"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2022.107153"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112445"},{"key":"e_1_3_6_26_2","unstructured":"Midroni C Leimbigler P Baruah G. 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