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Clinical evaluation of a personalized artificial pancreas

机译：个性化人工胰腺的临床评价

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摘要

OBJECTIVE-An artificial pancreas (AP) that automatically regulates blood glucose would greatly improve the lives of individuals with diabetes. Such a device would prevent hypo- and hyperglycemia along with associated long- and short-term complications as well as ease some of the day-to-day burden of frequent blood glucose measurements and insulin administration. RESEARCH DESIGN AND METHODS-We conducted a pilot clinical trial evaluating an individualized, fully automated AP using commercial devices. Two trials (n = 22, n subjects = 17) were conducted using a multiparametric formulation of model predictive control and an insulinon- board algorithm such that the control algorithm, or "brain," can be embedded on a chip as part of a future mobile device. The protocol evaluated the control algorithm for three main challenges: 1) normalizing glycemia from various initial glucose levels, 2) maintaining euglycemia, and 3) overcoming an unannounced meal of 30 ?? 5 g carbohydrates. RESULTS-Initial glucose values ranged from 84-251 mg/dL. Blood glucose was kept in the near-normal range (80-180 mg/dL) for an average of 70% of the trial time. The low and high blood glucose indices were 0.34 and 5.1, respectively. CONCLUSIONS-These encouraging short-term results reveal the ability of a control algorithm tailored to an individual's glucose characteristics to successfully regulate glycemia, even when faced with unannounced meals or initial hyperglycemia. To our knowledge, this represents the first truly fully automated multiparametric model predictive control algorithm with insulinon- board that does not rely on user intervention to regulate blood glucose in individuals with type 1 diabetes. ? 2013 by the American Diabetes Association.
机译：目标 - 一种自动调节血糖的人工胰腺（AP）将大大改善糖尿病患者的生命。这种装置将防止低血糖和高血糖以及相关的长期和短期并发症以及频繁血糖测量和胰岛素给药的一些日常负担。研究设计和方法 - 使用商业设备进行了评估个性化的全自动AP的试验临床试验。使用模型预测控制和胰岛素板算法的多游戏制剂进行了两次试验（n = 22，n受试者= 17），使得控制算法或“大脑”可以作为未来的一部分嵌入芯片上移动设备。该协议评估了三种主要挑战的控制算法：1）将糖血症从各种初始血糖水平的标准化，2）维持Euglycemia，以及3）克服30？ 5克碳水化合物。结果 - 初始葡萄糖值范围为84-251 mg / dL。血糖在接近正常的范围内（80-180 mg / dL），平均分析时间为70％。低血糖指数分别为0.34和5.1。结论 - 这些令人鼓舞的短期结果揭示了对单个葡萄糖特征定制的控制算法能够成功调节糖血症，即使面对未经发布的膳食或初始高血糖症。为了我们的知识，这代表了具有胰岛素的第一个真正全自动的多体模型预测控制算法，不依赖于用户干预来调节1型糖尿病的个体中的血糖。还是2013年由美国糖尿病协会。

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  • 来源
    《Diabetes care》 |2013年第4期|共9页
  • 作者

    DassauE.; ZisserH.; HarveyR.A.; PercivalM.W.; GrosmanB.; BevierW.; AtlasE.; MillerS.; NimriR.; Jovanovi?L.; DoyleIIIF.J.;

  • 作者单位

    Department of Chemical Engineering University of California Santa Barbara CA United States;

    Department of Chemical Engineering University of California Santa Barbara CA United States;

    Department of Chemical Engineering University of California Santa Barbara CA United States;

    Department of Chemical Engineering University of California Santa Barbara CA United States;

    Department of Chemical Engineering University of California Santa Barbara CA United States;

    Sansum Diabetes Research Institute Santa Barbara CA United States;

    Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes National Center for;

    Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes National Center for;

    Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes National Center for;

    Department of Chemical Engineering University of California Santa Barbara CA United States;

    Department of Chemical Engineering University of California Santa Barbara CA United States;

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  • 正文语种 eng
  • 中图分类 内分泌腺疾病及代谢病;
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