AI Article Synopsis

  • This study addresses the longstanding challenge of quickly reducing high blood sugar levels in type-1 diabetes without causing dangerously low levels (hypoglycemia).
  • It introduces a new control algorithm that ensures hypoglycemia is avoided while adjusting blood sugar in real-time, utilizing a validated feedback mechanism.
  • Simulations on a diverse group of virtual patients show promising results, paving the way for future clinical trials to test this hypo-free strategy in real-life scenarios.

Article Abstract

Driving blood glycaemia from hyperglycaemia to euglycaemia as fast as possible while avoiding hypoglycaemia is a major problem for decades for type-1 diabetes and is solved in this study. A control algorithm is designed that guaranties hypoglycaemia avoidance for the first time both from the theory of positive systems point of view and from the most pragmatic clinical practice. The solution consists of a state feedback control law that computes the required hyperglycaemia correction bolus in real-time to safely steer glycaemia to the target. A rigorous proof is given that shows that the control-law respects the positivity of the control and of the glucose concentration error: as a result, no hypoglycaemic episode occurs. The so-called hypo-free strategy control is tested with all the UVA/Padova T1DM simulator patients (i.e. ten adults, ten adolescents, and ten children) during a fasting-night scenario and in a hybrid closed-loop scenario including three meals. The theoretical results are assessed by the simulations on a large cohort of virtual patients and encourage clinical trials.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8687212PMC
http://dx.doi.org/10.1049/iet-syb.2018.5069DOI Listing

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Article Synopsis
  • This study addresses the longstanding challenge of quickly reducing high blood sugar levels in type-1 diabetes without causing dangerously low levels (hypoglycemia).
  • It introduces a new control algorithm that ensures hypoglycemia is avoided while adjusting blood sugar in real-time, utilizing a validated feedback mechanism.
  • Simulations on a diverse group of virtual patients show promising results, paving the way for future clinical trials to test this hypo-free strategy in real-life scenarios.
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Comparison of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy for glycaemic control in patients with type 1 diabetes: an open-label randomised controlled crossover trial.

Lancet Diabetes Endocrinol

January 2015

Institut de Recherches Cliniques de Montreal, Montreal, QC, Canada; Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC, Canada; Nutrition Department, Faculty of Medicine, Université de Montreal, Montreal, QC, Canada; Montreal Diabetes Research Center, Montreal, QC, Canada.

Background: The artificial pancreas is an emerging technology for the treatment of type 1 diabetes and two configurations have been proposed: single-hormone (insulin alone) and dual-hormone (insulin and glucagon). We aimed to delineate the usefulness of glucagon in the artificial pancreas system.

Methods: We did a randomised crossover trial of dual-hormone artificial pancreas, single-hormone artificial pancreas, and conventional insulin pump therapy (continuous subcutaneous insulin infusion) in participants aged 12 years or older with type 1 diabetes.

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