Safety auxiliary feedback element for the artificial pancreas in type 1 diabetes. 2013

A Revert, and F Garelli, and J Pico, and H De Battista, and P Rossetti, and J Vehi, and J Bondia
Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia 46022, Spain. anreto@upvnet.upv.es

The artificial pancreas aims at the automatic delivery of insulin for glycemic control in patients with type 1 diabetes, i.e., closed-loop glucose control. One of the challenges of the artificial pancreas is to avoid controller overreaction leading to hypoglycemia, especially in the late postprandial period. In this study, an original proposal based on sliding mode reference conditioning ideas is presented as a way to reduce hypoglycemia events induced by a closed-loop glucose controller. The method is inspired in the intuitive advantages of two-step constrained control algorithms. It acts on the glucose reference sent to the main controller shaping it so as to avoid violating given constraints on the insulin-on-board. Some distinctive features of the proposed strategy are that 1) it provides a safety layer which can be adjusted according to medical criteria; 2) it can be added to closed-loop controllers of any nature; 3) it is robust against sensor failures and overestimated prandial insulin doses; and 4) it can handle nonlinear models. The method is evaluated in silico with the ten adult patients available in the FDA-accepted UVA simulator.

UI MeSH Term Description Entries
D007328 Insulin A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1). Iletin,Insulin A Chain,Insulin B Chain,Insulin, Regular,Novolin,Sodium Insulin,Soluble Insulin,Chain, Insulin B,Insulin, Sodium,Insulin, Soluble,Regular Insulin
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D003198 Computer Simulation Computer-based representation of physical systems and phenomena such as chemical processes. Computational Modeling,Computational Modelling,Computer Models,In silico Modeling,In silico Models,In silico Simulation,Models, Computer,Computerized Models,Computer Model,Computer Simulations,Computerized Model,In silico Model,Model, Computer,Model, Computerized,Model, In silico,Modeling, Computational,Modeling, In silico,Modelling, Computational,Simulation, Computer,Simulation, In silico,Simulations, Computer
D003922 Diabetes Mellitus, Type 1 A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence. Diabetes Mellitus, Brittle,Diabetes Mellitus, Insulin-Dependent,Diabetes Mellitus, Juvenile-Onset,Diabetes Mellitus, Ketosis-Prone,Diabetes Mellitus, Sudden-Onset,Diabetes, Autoimmune,IDDM,Autoimmune Diabetes,Diabetes Mellitus, Insulin-Dependent, 1,Diabetes Mellitus, Type I,Insulin-Dependent Diabetes Mellitus 1,Juvenile-Onset Diabetes,Type 1 Diabetes,Type 1 Diabetes Mellitus,Brittle Diabetes Mellitus,Diabetes Mellitus, Insulin Dependent,Diabetes Mellitus, Juvenile Onset,Diabetes Mellitus, Ketosis Prone,Diabetes Mellitus, Sudden Onset,Diabetes, Juvenile-Onset,Diabetes, Type 1,Insulin Dependent Diabetes Mellitus 1,Insulin-Dependent Diabetes Mellitus,Juvenile Onset Diabetes,Juvenile-Onset Diabetes Mellitus,Ketosis-Prone Diabetes Mellitus,Sudden-Onset Diabetes Mellitus
D004360 Drug Therapy, Computer-Assisted Adjunctive computer programs in providing drug treatment to patients. Computer-Assisted Drug Therapy,Protocol Drug Therapy, Computer-Assisted,Therapy, Computer-Assisted Drug,Computer Assisted Drug Therapy,Computer-Assisted Drug Therapies,Drug Therapies, Computer-Assisted,Drug Therapy, Computer Assisted,Protocol Drug Therapy, Computer Assisted,Therapies, Computer-Assisted Drug,Therapy, Computer Assisted Drug
D004869 Equipment Safety Freedom of equipment from actual or potential hazards. Device Safety,Hazards, Equipment,Medical Device Safety,Safety, Equipment,Device Safety, Medical,Safety, Medical Device,Equipment Hazard,Equipment Hazards,Hazard, Equipment,Safety, Device
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015190 Blood Glucose Self-Monitoring Self evaluation of whole blood glucose levels outside the clinical laboratory. A digital or battery-operated reflectance meter may be used. It has wide application in controlling unstable insulin-dependent diabetes. Blood Sugar Self-Monitoring,Home Blood Glucose Monitoring,Monitoring, Home Blood Glucose,Self-Monitoring, Blood Glucose,Glucose, Blood, Self Monitoring,Glucose, Blood, Self-Monitoring,Blood Glucose Self Monitoring,Blood Glucose Self-Monitorings,Blood Sugar Self Monitoring,Blood Sugar Self-Monitorings,Glucose Self-Monitoring, Blood,Glucose Self-Monitorings, Blood,Self Monitoring, Blood Glucose,Self-Monitoring, Blood Sugar,Self-Monitorings, Blood Glucose,Self-Monitorings, Blood Sugar,Sugar Self-Monitoring, Blood,Sugar Self-Monitorings, Blood
D019397 Pancreas, Artificial Devices for simulating the activity of the pancreas. They can be either electromechanical, consisting of a glucose sensor, computer, and insulin pump or bioartificial, consisting of isolated islets of Langerhans in an artificial membrane. Artificial Pancreas
D025461 Feedback, Physiological A mechanism of communication with a physiological system for homeostasis, adaptation, etc. Physiological feedback is mediated through extensive feedback mechanisms that use physiological cues as feedback loop signals to control other systems. Feedback, Biochemical,Feedback Inhibition, Biochemical,Feedback Regulation, Biochemical,Feedback Stimulation, Biochemical,Negative Feedback, Biochemical,Positive Feedback, Biochemical,Biochemical Feedback,Biochemical Feedback Inhibition,Biochemical Feedback Inhibitions,Biochemical Feedback Regulation,Biochemical Feedback Regulations,Biochemical Feedback Stimulation,Biochemical Feedback Stimulations,Biochemical Feedbacks,Biochemical Negative Feedback,Biochemical Negative Feedbacks,Biochemical Positive Feedback,Biochemical Positive Feedbacks,Feedback Inhibitions, Biochemical,Feedback Regulations, Biochemical,Feedback Stimulations, Biochemical,Feedback, Biochemical Negative,Feedback, Biochemical Positive,Feedbacks, Biochemical,Feedbacks, Biochemical Negative,Feedbacks, Biochemical Positive,Feedbacks, Physiological,Inhibition, Biochemical Feedback,Inhibitions, Biochemical Feedback,Negative Feedbacks, Biochemical,Physiological Feedback,Physiological Feedbacks,Positive Feedbacks, Biochemical,Regulation, Biochemical Feedback,Regulations, Biochemical Feedback,Stimulation, Biochemical Feedback,Stimulations, Biochemical Feedback

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