{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:15:17Z","timestamp":1790061317099,"version":"4.0.1"},"reference-count":13,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T00:00:00Z","timestamp":1553040000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/501100003092","name":"Dutch Diabetes Research Foundation","doi-asserted-by":"crossref","award":["2016.30.004"],"award-info":[{"award-number":["2016.30.004"]}],"id":[{"id":"10.13039\/501100003092","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Changes in heart rate variability (HRV) occur at the initiation of hypoglycemia due to sympathetic nervous system activity. We investigated the use of HRV detection by a wearable device as an early alert for hypoglycemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This proof-of-principle study included 23 patients with type 1 diabetes (14 women, mean age 42 \u00b1 11 years). Patients wore a VitalConnect HealthPatch for 5 days. Hypoglycemia was defined as glucose \u226470 mg\/dL (\u22643.9 mmol\/L) by fingerstick measurement. HRV was analyzed in standardized periods before the hypoglycemic event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Sixty-six hypoglycemic events were recorded. Hypoglycemia caused a typical HRV pattern in 36 (55%) of the hypoglycemic events. Eighteen events (27%) showed an atypical pattern. Ten events were unclassified (15%), and two did not display a change in HRV (3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Hypoglycemia causes early changes in HRV that can be detected by a wearable device. Measuring real-time HRV seems promising for early hypoglycemia detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc18-1843","type":"journal-article","created":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T15:09:18Z","timestamp":1552662558000},"page":"689-692","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":57,"title":["Early Detection of Hypoglycemia in Type 1 Diabetes Using Heart Rate Variability Measured by a Wearable Device"],"prefix":"10.2337","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2619-3897","authenticated-orcid":false,"given":"Marleen","family":"Olde Bekkink","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Koeneman","sequence":"additional","affiliation":[{"name":"REshape Center for Innovation, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastiaan E.","family":"de Galan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian J.","family":"Bredie","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands"},{"name":"REshape Center for Innovation, Radboud University Medical Center, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2019,3,11]]},"reference":[{"key":"2022031300013227000_B1","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.2337\/dc12-2480","article-title":"Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the 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