The aim of METABO is to set up a comprehensive platform, running both in clinical settings and in every-day life environments, for continuous and multi-parametric monitoring of the metabolic status in patients with, or at risk of, diabetes and associated metabolic disorders. The type of parameters that will be monitored, in addition to ¿traditional¿ clinical and biomedical parameters, will also include subcutaneous glucose concentration, dietary habits, physical activity and energy expenditure, effects of ongoing treatments, and autonomic reactions. The data produced by METABO will be integrated with the clinical data and the history of the patient and will be used in two major interrelated contexts of care:

1. Setting up a dynamic model of the metabolic behavior of the individual to predict the influence and relative impact of specific treatments and of single parameters on glucose level.

2. Building personalized care plans integrated in the current clinical processes linking the different actors in primary and secondary care and improving the active role of the Patient.

The combined use of tools for predictive modelling and for the personalisation of the individual process of care will close the loop between the Patients, the Professionals involved and the Health Organisation. Mining the data produced by METABO will allow the identification of patterns and trends that will allow the fine tuning of the model and the prompt adjustment of the process of care. Three major clinical scenarios would achieve the best benefit from this close-loop approach:

1. Patients who do not reach an optimal metabolic control despite an optimalized clinical management. In these patients, the monitoring-and-modelling approach can be used by the patients and the medical team to identify specific therapeutic or lifestyle causes for sub-optimal glycemic control and provide specific suggestions for small, but significant changes in treatment, dietary habits and physical activity.

2. Patients who are at optimal/ acceptable metabolic control but who are at risk for hypoglycemia, especially if unaware of hypoglycemic symptoms. In these patients a continuous monitoring system would allow to identify early pre-symptomatic signs of hypoglycemic episodes with major advantages, especially in contexts where loss of coordination and consciousness might be life-threatening.

3. Patients who are exposed to continuous sudden changes in the environmental situation (i.e. frequent travelling, night shifts, etc.) and in geographical location and context of care.