{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T07:21:59Z","timestamp":1787642519282,"version":"build-2736575974"},"reference-count":82,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"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":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Physical activity (PA) lowers blood glucose (BG) levels in individuals with Type 1 Diabetes Mellitus (T1DM), with effects varying by intensity and duration. Predicting BG fluctuations under free-living conditions, beyond structured exercise, helps reduce hypoglycaemia risk. This study aimed to model and predict BG responses across varying PA levels using personalised, activity-informed temporal patterns derived from continuous glucose monitoring (CGM) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fourteen adults with T1DM were monitored under free-living conditions using Garmin smartwatches for PA tracking and CGM devices for BG measurement. PA was quantified using step count and maxMotion intensity, and categorised into four levels: low, medium, high, and very high. A 10-day rolling window (moving average) was applied to each participant\u2019s data to construct the personalised ACTIVE-GLU model, which estimates mean BG change at 15-minute intervals following PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ACTIVE-GLU model accurately predicted BG changes across all PA intensities. The lowest average accuracy (81.67%) was observed under low PA, while the highest prediction error occurred during very high PA (MAE = 0.44 mmol\/L, RMSE = 0.57 mmol\/L, mean bound deviation = 0.38 mmol\/L). Bland-Altman analysis confirmed close agreement between predicted and observed BG values, with negligible bias across intensity levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this exploratory cohort study, quantifying daily PA within a personalised temporal framework enables accurate prediction of BG responses in T1DM under real-world conditions. By incorporating PA intensity into BG dynamics, ACTIVE-GLU provides a personalised, PA-aware framework that may support interpretation of BG trends and inform future decision-support strategies. Future work will validate the model using virtual participants to simulate adaptive dosing interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076261456506","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:14:13Z","timestamp":1783325653000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["ACTIVE-GLU: Personalised modelling of physical activity-driven glucose dynamics in type 1 diabetes under free-living conditions"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-122X","authenticated-orcid":false,"given":"Ahmad","family":"Bilal","sequence":"first","affiliation":[{"name":"The University of Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hood","family":"Thabit","sequence":"additional","affiliation":[{"name":"Manchester University NHS"},{"name":"The University of Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W.","family":"Nutter","sequence":"additional","affiliation":[{"name":"The University of Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9301-5049","authenticated-orcid":false,"given":"Simon","family":"Harper","sequence":"additional","affiliation":[{"name":"The University of Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238094"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/db08-1084"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4026"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.2337\/dci19-0028"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05263-9"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102955"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296814566231"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30014-1"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0963"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15277"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2016-000143"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.2337\/db07-1605"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00014.2015"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1728"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2026.1718510"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.2196\/18694"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(22)00111-X"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2022.103888"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering8060072"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296818820550"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2014.09.038"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.2196\/34699"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296818823792"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcdhc.2022.1066744"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31320-5"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.2337\/cd18-0012"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.3390\/s18030884"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41597-023-02469-5"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41597-023-02737-4"},{"key":"e_1_3_8_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296814532906"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41597-025-05695-1"},{"key":"e_1_3_8_33_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2017.0054"},{"key":"e_1_3_8_34_2","unstructured":"Garmin Ltd. 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