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首页> 外文会议>Annual American Control Conference >In silico evaluation of a Parallel Control-based Coordinated Dual-Hormone Artificial Pancreas with Insulin on Board Limitation
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In silico evaluation of a Parallel Control-based Coordinated Dual-Hormone Artificial Pancreas with Insulin on Board Limitation

机译：局限性胰岛素平行控制基于协调的双激素人工胰腺的计算机评估

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A closed-loop glucose control system with automatic insulin and glucagon delivery (dual-hormone artificial pancreas) has the potential to reduce the self-management and the risk of hypo- and hyperglycemia in type 1 diabetic subjects. A novel dual-hormone closed-loop system based on a parallel control structure with intrinsic coordination among insulin and glucagon delivery is presented here, and the potential benefit of incorporating insulin-on-board limitation in such scheme is analyzed. To this end, the coordinated configuration (CC) has been extended with insulin-on-board (IOB) limitation through Sliding Mode Reference Conditioning (CC-SMRC), previously successfully tested in the context of single-hormone systems. Performance of CC and CC-SMRC has been compared through an in-silico study using the UVA-Padova simulator, extended to include various sources of variability. Three scenarios have been considered, comprising meals, snacks and exercise. The proposed coordinated strategy with the IOB limitation showed slightly lower time in hypoglycemia in meal and meals+snack scenario (0.00% vs 0.14% in meal scenario; 0.01% vs 0.11% in snack scenario), but they were not statistically significant ($mathbf{p}=0.180$ and $mathbf{p}=0.179$, respectively). However, the reduction during exercise scenario was statistically significant (1.45% vs 3.40%, $mathbf{p} < 0.001$). Likewise, the time in range was similar in both configurations during meal and meals+snack scenarios (93.80% vs 94.13%, $mathbf{p}=0.803$, in meal scenario; 93.97% vs 94.32%, $mathbf{p}=0.356$, in meals+snack; CC-SMRC vs CC), although it was greater in CC-SMRC during exercise scenario (92.98% vs 91.56%, $mathbf{p}=0.023$; CC-SMRC vs CC). Moreover, insulin delivery was lower in CC-SMRC during the most demanding exercise scenario (45.91 /day vs 46.53U/day, $mathbf{p}=0.001$) at the expense of higher glucagon delivery to reduce hypoglycemia ($1.03pm 0.83mathbf{mg}/mathbf{day}$ vs $0.96pm 0.79, mathbf{p}= 0.001$). In conclusion, the coordinated configuration with insulin-on-board limitation demonstrated to be able to improve the performance of the coordinated configuration faced with exercise perturbation.
机译：具有自动胰岛素和胰高血糖素递送功能的闭环葡萄糖控制系统（双激素人工胰腺）有可能降低1型糖尿病患者的自我管理以及低血糖和高血糖风险。本文提出了一种基于平行控制结构的新型双激素闭环系统，该结构具有胰岛素和胰高血糖素的内在协调性，并分析了在这种方案中纳入机载胰岛素的潜在益处。为此，协调配置（CC）已通过滑动模式参考条件（CC-SMRC）扩展了机载胰岛素（IOB）限制，先前已在单激素系统的环境中成功进行了测试。 CC和CC-SMRC的性能已通过使用UVA-Padova模拟器的计算机模拟研究进行了比较，该模拟器已扩展为包括各种可变性来源。已经考虑了三种情况，包括进餐，点心和运动。提出的具有IOB限制的协调策略显示，在进餐和进餐加零食的情况下发生低血糖的时间略短（0.00％vs.0.14％在进餐情况下; 0.01％vs.0.11％在零食情况下），但在统计学上不显着（ $ \ mathbf {p} = 0.180 $ 和 $ \ mathbf {p} = 0.179美元 ， 分别）。但是，运动过程中的减少幅度具有统计学意义（1.45％对3.40％， $ \ mathbf {p} < 0.001美元 ）。同样，在进餐和进餐+零食的情况下，两种配置的续航时间相似（93.80％vs 94.13％， $ \ mathbf {p} = 0.803 $ ，在用餐情况下; 93.97％对94.32％， $ \ mathbf {p} = 0.356 $ ，含餐点+小吃; CC-SMRC与CC），尽管在锻炼过程中CC-SMRC的比例更高（92.98％对91.56％， $ \ mathbf {p} = 0.023美元 ; CC-SMRC与CC）。此外，在最苛刻的运动情况下，CC-SMRC中的胰岛素输送量较低（45.91 /天与46.53U /天， $ \ mathbf {p} = 0.001美元 ）以更高的胰高血糖素释放量来降低低血糖（ $ 1.03 \ pm 0.83 \ mathbf { mg} / \ mathbf {day} $ 与 $ 0.96 \ pm 0.79，\ mathbf {p} = 0.001 $ ）。总之，具有机上胰岛素限制的协调构型证明能够改善面对运动扰动的协调构型的性能。

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