Publications by authors named "Mirko Messori"
Toward a Run-to-Run Adaptive Artificial Pancreas: In Silico Results.
IEEE Trans Biomed Eng
March 2018
Objective: Contemporary and future outpatient long-term artificial pancreas (AP) studies need to cope with the well-known large intra- and interday glucose variability occurring in type 1 diabetic (T1D) subjects. Here, we propose an adaptive model predictive control (MPC) strategy to account for it and test it in silico.
Methods: A run-to-run (R2R) approach adapts the subcutaneous basal insulin delivery during the night and the carbohydrate-to-insulin ratio (CR) during the day, based on some performance indices calculated from subcutaneous continuous glucose sensor data.
Article Synopsis
- The study aimed to examine the experiences of children with type 1 diabetes and their parents during a 7-day summer camp focused on an artificial pancreas clinical trial.
- Interviews revealed that while parents were mainly curious about the device's safety and effectiveness, children were excited about trying out the new technology.
- Results showed that most parents found the artificial pancreas easy to use and believed it could improve glucose control, indicating a generally positive reception and the need for further research to better tailor the device to participants' needs.
Background And Objective: The inter-subject variability characterizing the patients affected by type 1 diabetes mellitus makes automatic blood glucose control very challenging. Different patients have different insulin responses, and a control law based on a non-individualized model could be ineffective. The definition of an individualized control law in the context of artificial pancreas is currently an open research topic.
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- The PedArPan project tested a children's version of the modular model predictive control (MMPC) algorithm in children aged 5 to 9 with type 1 diabetes during a camp outing.
- In a randomized trial with 30 participants, the artificial pancreas (AP) was compared to parent-managed sensor-augmented pump (SAP) over six days.
- Results indicated that the AP significantly reduced overnight hypoglycemia but also led to higher average glucose levels and slightly decreased time within the target glucose range, suggesting that algorithm improvements are needed for better efficacy.
Article Synopsis
- This study investigated the effectiveness of a wearable artificial pancreas (AP) for managing blood sugar levels in adults with type 1 diabetes during both day and night over a month.
- Results showed that the D/N-AP (Day/Night-AP) maintained similar time-in-target glucose levels as the E/N-AP (Evening/Night-AP) and outperformed a traditional sensor augmented pump (SAP) in reducing low blood sugar incidents.
- The D/N-AP demonstrated lower blood glucose variability during the day compared to the E/N-AP and the SAP, indicating it may offer improved glucose control in a free-living environment.
Article Synopsis
- An artificial pancreas (AP) that can be worn overnight appears to improve glucose control in type 1 diabetes patients compared to traditional sensor-augmented pump therapy (SAP) used continuously.
- In a crossover study involving patients from France, Italy, and the Netherlands, participants used the AP at night and managed SAP during the day, while another group only used SAP for the entire study duration.
- Results showed that AP users spent an average of 66.7% of the night in the target glucose range, significantly higher than the 58.1% for SAP users, indicating better nighttime glucose management with the AP.
Article Synopsis
- The study aimed to assess how closed-loop control (CLC) affects hypoglycemia risk compared to open-loop (OL) insulin pump therapy in patients with type 1 diabetes.
- Conducted with 20 participants over two 40-hour sessions, the results indicated that CLC significantly reduced the incidence of hypoglycemia compared to OL, showing a twofold reduction in episodes requiring treatment.
- However, this hypoglycemia reduction came with a slight increase in average blood glucose levels, suggesting that the safety measures for preventing low blood sugar may have slightly compromised overall glycemic control.
Article Synopsis
- This study examines the effectiveness of model predictive control (MPC) in a wearable artificial pancreas (AP) for managing postprandial glucose levels in type 1 diabetes patients in an outpatient setting.
- Six participants were tested over 42 hours, comparing sensor-augmented pump therapy with closed-loop MPC, showing significant improvement in glucose control during meals and overnight.
- The findings indicate that MPC strategies are promising for outpatient glucose management, suggesting further research through randomized crossover studies.
Artificial pancreas: model predictive control design from clinical experience.
J Diabetes Sci Technol
November 2013
Background: The objective of this research is to develop a new artificial pancreas that takes into account the experience accumulated during more than 5000 h of closed-loop control in several clinical research centers. The main objective is to reduce the mean glucose value without exacerbating hypo phenomena. Controller design and in silico testing were performed on a new virtual population of the University of Virginia/Padova simulator.
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