Citation

BibTex format

@article{Herrero:2017:10.1016/j.cmpb.2017.05.010,
author = {Herrero, P and Bondia, J and Adewuyi, O and Pesl, P and El-Sharkawy, M and Reddy, M and Toumazou, C and Oliver, N and Georgiou, P},
doi = {10.1016/j.cmpb.2017.05.010},
journal = {Computer Methods and Programs in Biomedicine},
pages = {125--131},
title = {Enhancing automatic closed-loop glucose control in type 1 diabetes with an adaptive meal bolus calculator - in silico evaluation under intra- day variability},
url = {http://dx.doi.org/10.1016/j.cmpb.2017.05.010},
volume = {146},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background and ObjectiveCurrent prototypes of closed-loop systems for glucose control in type 1 diabetes mellitus, also referred to as artificial pancreas systems, require a pre-meal insulin bolus to compensate for delays in subcutaneous insulin absorption in order to avoid initial post-prandial hyperglycemia. Computing such a meal bolus is a challenging task due to the high intra-subject variability of insulin requirements. Most closed-loop systems compute this pre-meal insulin dose by a standard bolus calculation, as is commonly found in insulin pumps. However, the performance of these calculators is limited due to a lack of adaptiveness in front of dynamic changes in insulin requirements. Despite some initial attempts to include adaptation within these calculators, challenges remain.MethodsIn this paper we present a new technique to automatically adapt the meal-priming bolus within an artificial pancreas. The technique consists of using a novel adaptive bolus calculator based on Case-Based Reasoning and Run-To-Run control, within a closed-loop controller. Coordination between the adaptive bolus calculator and the controller was required to achieve the desired performance. For testing purposes, the clinically validated 51³Ô¹ÏÍø College Artificial Pancreas controller was employed. The proposed system was evaluated against itself but without bolus adaptation. The UVa-Padova T1DM v3.2 system was used to carry out a three-month in silico study on 11 adult and 11 adolescent virtual subjects taking into account inter-and intra-subject variability of insulin requirements and uncertainty on carbohydrate intake.ResultsOverall, the closed-loop controller enhanced by an adaptive bolus calculator improves glycemic control when compared to its non-adaptive counterpart. In particular, the following statistically significant improvements were found (non-adaptive vs. adaptive). Adults: mean glucose 142.2 ± 9.4 vs. 131.8 ± 4.2 mg/dl; perce
AU  - Herrero,P
AU  - Bondia,J
AU  - Adewuyi,O
AU  - Pesl,P
AU  - El-Sharkawy,M
AU  - Reddy,M
AU  - Toumazou,C
AU  - Oliver,N
AU  - Georgiou,P
DO  - 10.1016/j.cmpb.2017.05.010
EP  - 131
PY  - 2017///
SN  - 0169-2607
SP  - 125
TI  - Enhancing automatic closed-loop glucose control in type 1 diabetes with an adaptive meal bolus calculator - in silico evaluation under intra- day variability
T2  - Computer Methods and Programs in Biomedicine
UR  - http://dx.doi.org/10.1016/j.cmpb.2017.05.010
VL  - 146
ER  -
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