There is growing evidence that sex and gender affect the pathophysiology, incidence, prevalence, development and response to therapy in many diseases [22]. This is the case of diabetes, where factors such as differences in lifestyle (diet and exercise), sex hormones and body composition, produce differences in glucose regulation between women and men.

The overall goal of this project is the personalization of insulin therapy according to physiological differences in women and men for a better glycemic control, especially among women who suffer higher challenges due to the glycemic effects of menstrual cycle. Emphasis will be put in the development of new decision support systems for MDI therapy incorporating real-time monitoring of menstrual cycle phases in women. Evaluation of the need of sex-specific control algorithms for the artificial pancreas will also be carried out, as well as proof-of-concept simulation study evaluating a sex-specific version of our artificial pancreas. 

This general objective is broken down into the following more specific scientific objectives:

• Development of new models describing physiological differences between women and men, with regard to exercise and meal disturbances.
• Development of new physiological and data-based simulation tools for the development of sex-specific glucose control algorithms, with emphasis in MDI therapy.
• Development and clinical evaluation of new wearable technology for real-time monitoring of relevant information on menstrual cycle phases in women.
• Development and clinical evaluation of new control and decision support systems for MDI therapy.
• Development of sex-specific algorithms for the artificial pancreas
• Effective exploitation of the results within the timespan of the project.

The expected contributions of DIABETEXX are:

• To address specific needs of women with type 1 diabetes for the improvement of glycemic control, with higher incidence of all-cause mortality and likelihood of vascular events.
• The development of new type 1 diabetes simulation tools able to differentiate between women and men, for the design of sex-specific insulin therapies, both DSS in MDI and artificial pancreas.
• The development and clinical evaluation of innovative technologies, such as new decision support systems for MDI insulin therapy with sex-specific algorithms, and new wearable technology automatically monitoring relevant information on menstrual cycle phases in women.