On-line adaptive algorithm with glucose prediction capacity for subcutaneous closed loop control of glucose: evaluation under fasting conditions in patients with Type 1 diabetes

Aims To evaluate an algorithm with glucose prediction capacity and continuous adaptation of patient parameters—a model predictive control (MPC) algorithm—to control blood glucose concentration during fasting conditions in patients with Type 1 diabetes. In the subcutaneous (sc) route within a closed...

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Bibliographic Details
Published in:	Diabetic medicine Vol. 23; no. 1; pp. 90 - 93
Main Authors:	Schaller, H. C., Schaupp, L., Bodenlenz, M., Wilinska, M. E., Chassin, L. J., Wach, P., Vering, T., Hovorka, R., Pieber, T. R.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Ltd 01.01.2006 Blackwell
Subjects:	Administration, Cutaneous Algorithms artificial β-cell Biological and medical sciences Blood Glucose - analysis Computer Simulation continuous subcutaneous insulin infusion Diabetes Mellitus, Type 1 - blood Diabetes. Impaired glucose tolerance Drug Administration Schedule Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Fasting Female glucose control glucose monitoring Humans Insulin - administration & dosage Insulin - blood Insulin Infusion Systems Male Medical sciences Models, Biological Endocrinopathy Human Immunopathology algorithms Adaptive algorithm Subcutaneous Langerhans islet Autoimmune disease Glucose glucose monitoring continuous subcutaneous insulin infusion Surveillance Type 1 diabetes Insulin pump glucose control β Cell Predictive factor Fast Glycemia artificial β-cell Endocrine pancreas
ISSN:	0742-3071, 1464-5491
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Summary:	Aims To evaluate an algorithm with glucose prediction capacity and continuous adaptation of patient parameters—a model predictive control (MPC) algorithm—to control blood glucose concentration during fasting conditions in patients with Type 1 diabetes. In the subcutaneous (sc) route within a closed loop system. Methods Paired experiments were performed in six patients. Over 8 h the MPC algorithm was used to control glucose with s.c. insulin administration and two different glucose monitoring protocols: first, the algorithm was provided with intravenous (i.v.) glucose values for insulin dosage calculation directly (i.v.–s.c. route). Then, in the second experiment, i.v. glucose values were fed to the MPC with a delay of 30 min to simulate s.c. glucose measurements (‘s.c.’–s.c. route). In both experiments plasma glucose, insulin dosage, and serum insulin levels were analysed. Results Glucose concentration was brought from hyper‐ to normoglycaemia and kept in the physiological range (6–7 mmol/l) with both routes in all subjects. Mean glucose concentration reached the threshold of 7 mmol/l approximately 2 (i.v.–s.c. route) and 3 (‘s.c.’–s.c. route) hours after the start of glucose control with the MPC. During the last 2 h of automated glucose control, mean glucose concentration was 6.3 ± 0.2 mmol/l and 6.6 ± 0.3 mmol/l for i.v.–s.c. and ‘s.c.’–s.c. route, respectively. Glucose concentration, insulin doses, and serum insulin levels did not differ significantly between routes (P > 0.05). Conclusions The MPC algorithm is suitable for glucose control during fasting within an extracorporeal artificial β‐cell in the subcutaneous route Type 1 diabetic patients.
Bibliography:	ark:/67375/WNG-1PKNPG43-9 ArticleID:DME1695 istex:2A4F176B6869C258D4BDC9DA981468B0BD8479F9 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0742-3071 1464-5491
DOI:	10.1111/j.1464-5491.2006.01695.x