Estimating endogenous glucose production during exercise using heart rate: implications for diabetes management

Non-invasive, continuous Endogenous glucose production (EGP) estimation during exercise would help manage and automate insulin and glucose dosing during exercise, providing novel information to more effectively close the loop in managing glucose levels. This study used a combination of new study and literature data to determine relationships between blood lactate concentrations, heart rate (HR), and EGP. From these relationships, EGP can be estimated based on HR, which is continuously and noninvasively available at low cost in exercise. Participants for the exercise protocol were 10 sub-elite athletes who participated in at least 6 hours per week of endurance sports. Lactate as a function of HR during high intensity (HI) exercise has variability R-2 = 0.49. The variability in the model curve using independent literature values is R-2 = 0.65. Using these results to create a model of EGP as a function of HR gives an R-2 = 0.80. This method provides a continuous and non-invasive means of estimating EGP during exercise, including at HI, which is more rarely studied, and can be used to improve diabetes management in exercise. Copyright (C) 2021 The Authors.