{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:38:47Z","timestamp":1792471127140,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015872","name":"Universit\u00e9 de Lille","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015872","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Some studies have explored associations between physical activity (PA) and hypoglycaemia in real\u2010life in type 1 diabetes (T1D) but without fully accounting for two major confounders, diet and insulin. We aimed to identify thresholds of PA characteristics, insulin, and carbohydrates associated with dysglycaemia across the exercise\u2010recovery cycle in children with T1D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Continuous glucose monitoring and accelerometry data, self\u2010reported PA sessions (timing, duration and perceived intensity), diet (timing, type and quantity; optional photographs) and insulin data (doses and timing; corrective\/meal boluses and basal insulin) were collected in 36 children with T1D (11.9\u2009\u00b1\u20093.3\u2009years, injections or open\u2010loop pumps) over seven free\u2010living days. Accelerometer data were analysed for periods corresponding to self\u2010reported PA sessions. Ensemble machine\u2010learning models classified hypoglycaemia (&lt;\u200970\u2009mg\/dL) and hyperglycaemia (&gt;\u2009180\u2009mg\/dL) during three phases: PA, 2\u2010h post\u2010exercise (early recovery), overnight. Shapley analysis identified risk and protection thresholds of features with high importance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Models achieved moderate to strong performance (AUC: 0.65\u20130.99; F1\u2010score: 0.62\u20130.95) across outcomes and phases. Insulin boluses &gt;\u200911% of total daily dose within 4\u2010h pre\u2010exercise and &gt;\u200917% during early recovery were associated with hypoglycaemia risk during PA and early recovery respectively. Carbohydrate intake showed collinearity with insulin, resulting in complex associations with glycaemia. Self\u2010reported PA &gt;\u200980\u2009min was associated with hypoglycaemia risk during PA, while accumulating &gt;\u200915\u2009min of accelerometer\u2010derived vigorous PA was actually protective against early recovery hypoglycaemia. Multiple daily sessions were associated with nocturnal hyperglycaemia protection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Phase\u2010specific thresholds across exercise and insulin domains associated with exercise\u2010related dysglycaemia were identified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71165","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T02:37:06Z","timestamp":1785724626000},"page":"9505-9517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identification of Activity, Insulin, and Dietary Thresholds Associated With Exercise\u2010Related Hypoglycaemia and Hyperglycaemia in Children With Type 1 Diabetes: A Free\u2010Living Study Using Explainable Machine Learning"],"prefix":"10.1111","volume":"28","author":[{"given":"Asif","family":"Iqbal","sequence":"first","affiliation":[{"name":"ULR 7369 \u2010 URePSSS \u2010 Unit\u00e9 de Recherche Pluridisciplinaire Sport Sant\u00e9 Soci\u00e9t\u00e9 Univ. Lille, Univ. Artois, Univ. Littoral C\u00f4te d'Opale  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haithem","family":"Dahimi","sequence":"additional","affiliation":[{"name":"ULR 7369 \u2010 URePSSS \u2010 Unit\u00e9 de Recherche Pluridisciplinaire Sport Sant\u00e9 Soci\u00e9t\u00e9 Univ. Lille, Univ. Artois, Univ. Littoral C\u00f4te d'Opale  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Preux","sequence":"additional","affiliation":[{"name":"CNRS, Inria, Centrale Lille, UMR 9189 \u2013 CRIStAL Universit\u00e9 de Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elodie","family":"Lespagnol","sequence":"additional","affiliation":[{"name":"ULR 7369 \u2010 URePSSS \u2010 Unit\u00e9 de Recherche Pluridisciplinaire Sport Sant\u00e9 Soci\u00e9t\u00e9 Univ. Lille, Univ. Artois, Univ. Littoral C\u00f4te d'Opale  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang\u00e9line","family":"Melin","sequence":"additional","affiliation":[{"name":"ULR 7369 \u2010 URePSSS \u2010 Unit\u00e9 de Recherche Pluridisciplinaire Sport Sant\u00e9 Soci\u00e9t\u00e9 Univ. Lille, Univ. Artois, Univ. Littoral C\u00f4te d'Opale  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Morel","sequence":"additional","affiliation":[{"name":"ULR 7369 \u2010 URePSSS \u2010 Unit\u00e9 de Recherche Pluridisciplinaire Sport Sant\u00e9 Soci\u00e9t\u00e9 Univ. Littoral C\u00f4te d'Opale, Univ. Artois, Univ. Lille  Dunkerque France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Heyman","sequence":"additional","affiliation":[{"name":"CNRS, UMR 6118, Transferts d'eau et de Mati\u00e8re dans les Milieux H\u00e9t\u00e9rog\u00e8nes Complexes \u2010 G\u00e9osciences Universit\u00e9 Rennes  Rennes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4706-5170","authenticated-orcid":false,"given":"R\u00e9mi","family":"Rabasa\u2010Lhoret","sequence":"additional","affiliation":[{"name":"Institut de Recherches Cliniques de Montr\u00e9al (IRCM)  Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Endocrinology Division Centre Hospitaller de l'Universit\u00e9 de Montr\u00e9al (CHUM)  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9340-7592","authenticated-orcid":false,"given":"Elsa","family":"Heyman","sequence":"additional","affiliation":[{"name":"ULR 7369 \u2010 URePSSS \u2010 Unit\u00e9 de Recherche Pluridisciplinaire Sport Sant\u00e9 Soci\u00e9t\u00e9 Univ. 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