Back to Search
Start Over
Glucose outcomes of a learning-type artificial pancreas with an unannounced meal in type 1 diabetes
- Source :
- Computer methods and programs in biomedicine. 191
- Publication Year :
- 2020
-
Abstract
- Background and Objectives Glycemic control with unannounced meals is the major challenge for artificial pancreas. In this study, we described the performance and safety of learning-type model predictive control (L-MPC) for artificial pancreas challenged by an unannounced meal in type 1 diabetes (T1D). Methods This closed-loop (CL) system was tested in 29 T1D patients at one site in a 4 h inpatient open-label study. Participants used an L-MPC CL system for 6 days after 2-day system identification using open-loop (OL) insulin system. During the CL period, the L-MPC system was started from 8:00 am to noon each day. At 9:00 am, each participant consumed 50 g of carbohydrates with no prandial insulin bolus. At 9:30 am on CL-Day 4 or CL-Day 6, participants rode bicycles for 20 minutes or drank 50 ml of beer, in a random order. Results As the primary outcome, TIR on CL-Day 3 was 65.2±23.3%, which was 9.8 points higher (95% CI 1.8 to 17.8; P = 0.019) than that on CL-Day 1. The time of glucose >10 mmol/L was decreased by 11.0% (95% CI -18.7 to 3.3; P = 0.007), and mean glucose level was decreased by 1.1 mmol/L (95% CI -1.1 to 0.5; P = 0.000). The total daily insulin dosage showed no significant difference (-0.1U, 95% CI -1.34 to 1.32; P = 0.982). Compared with OL-Day1 with a postprandial bolus, the TIR was increased by 13.7 points (95% CI 1.4 to 26.0; P = 0.030), the time of glucose >10 mmol/L and the mean glucose level were also decreased. Compared with the exercise day (CL-Day E, 62.0 ± 23.3%; P = 0.347) or alcohol day (CL-Day A, 64.0 ± 23.6%; P = 0.756), there was no statistically significant difference in terms of TIR, time of glucose >10 mmol/L and mean glucose level. No severe hypoglycemic events occurred and hypoglycemic episodes were not increased by using closed-loop insulin system. Conclusion The L-MPC CL insulin system achieved good glycemic control challenged by an unannounced meal.
- Subjects :
- Adult
Blood Glucose
Male
Pancreas, Artificial
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Health Informatics
Gastroenterology
Artificial pancreas
030218 nuclear medicine & medical imaging
Machine Learning
03 medical and health sciences
Young Adult
0302 clinical medicine
Bolus (medicine)
Insulin Infusion Systems
Internal medicine
Outcome Assessment, Health Care
Medicine
Humans
Meals
Glycemic
Aged
Type 1 diabetes
Meal
business.industry
Insulin
Insulin dosage
Middle Aged
medicine.disease
Computer Science Applications
Postprandial
Diabetes Mellitus, Type 1
Female
business
030217 neurology & neurosurgery
Software
Algorithms
Subjects
Details
- ISSN :
- 18727565
- Volume :
- 191
- Database :
- OpenAIRE
- Journal :
- Computer methods and programs in biomedicine
- Accession number :
- edsair.doi.dedup.....05e46864a995a40dd1a147889e8b2de2