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Postprandial response improvement via safety layer in closed-loop blood glucose controllers

Traditional type 1 diabetes therapies are prone to show poor glucose regulation especially in the postprandial period owing to both physiological and technological limitations. Although a closed-loop controller for glucose regulation has to be tuned to minimize the postprandial excursion and avoid late hypoglycemia, the intrinsic limitations of the problem lead to a trade-off between postprandial peak and late hypoglycemia risk. This paper reveals through an intensive in-silico study with multiple controller tuning combinations that a novel safety layer for glucose controllers, the so-called SAFE loop (Revert et al., 2013), not only reduces the hypoglycemia events but also allows reducing the postprandial glucose excursion, thus breaking the implicit trade-off present in single controllers. The SAFE outer loop monitors the estimated amount of insulin on board, and modifies the control action if it is close to a unique constraint which can be adjusted with clinical criteria. A very challenging test scenario is here implemented including the rate of blood glucose appearance from intakes of mixed meals, diurnal and day-to-day time-varying metabolic changes, inherent drawbacks in sensor and actuator, and other realistic conditions. The results show a significant reduction of hypoglycemia events when SAFE is added, regardless the closed-loop glucose controller, together with a potential postprandial response improvement

Research in this area is partially supported by the Spanish Ministry of Science and Innovation through grant DPI2010-20764-C02, the Government of Catalonia trough grant SGR00523, and the Argentinean Government (ANPCyT PICT-2011-0888 and 2012-0037, CONICET PIP112-2011-00361 and UNLP 1164). Fabian Leon-Vargas acknowledges the FI grants of the Government of Catalonia

© Biomedical Signal Processing and Control, 2015, vol. 16, p. 80-87

Elsevier

Author: Garelli, Fabricio
León Vargas, Fabian Mauricio
Garelli, Fabricio
Battista, Hernán de
Vehí, Josep
Date: 2015 January 1
Abstract: Traditional type 1 diabetes therapies are prone to show poor glucose regulation especially in the postprandial period owing to both physiological and technological limitations. Although a closed-loop controller for glucose regulation has to be tuned to minimize the postprandial excursion and avoid late hypoglycemia, the intrinsic limitations of the problem lead to a trade-off between postprandial peak and late hypoglycemia risk. This paper reveals through an intensive in-silico study with multiple controller tuning combinations that a novel safety layer for glucose controllers, the so-called SAFE loop (Revert et al., 2013), not only reduces the hypoglycemia events but also allows reducing the postprandial glucose excursion, thus breaking the implicit trade-off present in single controllers. The SAFE outer loop monitors the estimated amount of insulin on board, and modifies the control action if it is close to a unique constraint which can be adjusted with clinical criteria. A very challenging test scenario is here implemented including the rate of blood glucose appearance from intakes of mixed meals, diurnal and day-to-day time-varying metabolic changes, inherent drawbacks in sensor and actuator, and other realistic conditions. The results show a significant reduction of hypoglycemia events when SAFE is added, regardless the closed-loop glucose controller, together with a potential postprandial response improvement
Research in this area is partially supported by the Spanish Ministry of Science and Innovation through grant DPI2010-20764-C02, the Government of Catalonia trough grant SGR00523, and the Argentinean Government (ANPCyT PICT-2011-0888 and 2012-0037, CONICET PIP112-2011-00361 and UNLP 1164). Fabian Leon-Vargas acknowledges the FI grants of the Government of Catalonia
Format: application/pdf
ISSN: 1746-8094
Document access: http://hdl.handle.net/10256/11728
Language: eng
Publisher: Elsevier
Collection: MICINN/PN 2011-2013/DPI2010-20764-C02
AGAUR/2009-2014/2009 SGR-523
Reproducció digital del document publicat a: http://dx.doi.org/10.1016/j.bspc.2014.10.003
Articles publicats (D-EEEiA)
Is part of: © Biomedical Signal Processing and Control, 2015, vol. 16, p. 80-87
Rights: Tots els drets reservats
Subject: Glucèmia
Blood sugar
Hipoglucèmia
Hypoglycemia
Diabetis
Diabetes
Control, Teoria de
Control theory
Anàlisi de sistemes
System analysis
Control intel·ligent
Intelligent control systems
Control automàtic
Automatic control
Title: Postprandial response improvement via safety layer in closed-loop blood glucose controllers
Type: info:eu-repo/semantics/article
Repository: DUGiDocs

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