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Artificial pancreas

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https://www.readbyqxmd.com/read/28812204/multivariable-adaptive-artificial-pancreas-system-in-type-1-diabetes
#1
REVIEW
Ali Cinar
PURPOSE OF REVIEW: The review summarizes the current state of the artificial pancreas (AP) systems and introduces various new modules that should be included in future AP systems. RECENT FINDINGS: A fully automated AP must be able to detect and mitigate the effects of meals, exercise, stress and sleep on blood glucose concentrations. This can only be achieved by using a multivariable approach that leverages information from wearable devices that provide real-time streaming data about various physiological variables that indicate imminent changes in blood glucose concentrations caused by meals, exercise, stress and sleep...
August 15, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28802779/pharmacological-aspects-of-closed-loop-insulin-delivery-for-type-1-diabetes
#2
REVIEW
Chukwuma Uduku, Nick Oliver
Insulin deficiency and impaired glucose homeostasis are hallmarks of type 1 diabetes. Since the discovery of insulin, pharmacological and clinical developments have endeavoured to replicate its endogenous pharmacokinetics (PK) and pharmacodynamics (PD). Closed loop insulin delivery systems operate as an artificial pancreas by making automated insulin dose adjustments based on real time continuous glucose monitoring. The increasing adoption of continuous insulin pump therapy and evolving technological advances have seen significant progress in the development of closed loop insulin delivery systems...
August 10, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/28745095/an-enhanced-model-predictive-control-for-the-artificial-pancreas-using-a-confidence-index-based-on-residual-analysis-of-past-predictions
#3
Alejandro J Laguna Sanz, Francis J Doyle, Eyal Dassau
BACKGROUND: Model predictive control (MPC) performance depends on the accuracy of the prediction model implemented by the controller. Complex physiology and modeling limitations often prevent the ability to provide long and accurate glucose predictions, which results in the need to account for prediction errors. METHOD: Optimal insulin dosage by Zone-MPC is calculated by solving an optimization problem in which a scalar index is minimized by penalizing relative input deviations and glucose predictions out of the reference zone...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28734790/organ-weights-and-histopathology-of-double-crested-cormorants-phalacrocorax-auritus-dosed-orally-or-dermally-with-artificially-weathered-mississippi-canyon-252-crude-oil
#4
Kendal E Harr, Drury R Reavill, Steven J Bursian, Dave Cacela, Fred L Cunningham, Karen M Dean, Brian S Dorr, Katie C Hanson-Dorr, Kate Healy, Katherine Horak, Jane E Link, Susan Shriner, Robert E Schmidt
A series of toxicity tests were conducted to assess the effects of low to moderate exposure to artificially weathered Deepwater Horizon Mississippi Canyon 252 crude oil on representative avian species as part of the Natural Resource Damage Assessment. The present report summarizes effects of oral exposure (n=26) of double-crested cormorants (DCCO; Phalacrocorax auritus) to 5 or 10ml oil kg(-1) day(-1) for up to 21 days or dermal application (n=25) of 13ml oil to breast and back feathers every three days totaling 6 applications in 21 days on organ weights and histopathology...
July 19, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28728434/economic-model-predictive-control-of-bihormonal-artificial-pancreas-system-based-on-switching-control-and-dynamic-r-parameter
#5
Fengna Tang, Youqing Wang
BACKGROUND: Blood glucose (BG) regulation is a long-term task for people with diabetes. In recent years, more and more researchers have attempted to achieve automated regulation of BG using automatic control algorithms, called the artificial pancreas (AP) system. In clinical practice, it is equally important to guarantee the treatment effect and reduce the treatment costs. The main motivation of this study is to reduce the cure burden. METHODS: The dynamic R-parameter economic model predictive control (R-EMPC) is chosen to regulate the delivery rates of exogenous hormones (insulin and glucagon)...
July 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28688482/enhancing-automatic-closed-loop-glucose-control-in-type-1-diabetes-with-an-adaptive-meal-bolus-calculator-in-silico-evaluation-under-intra-day-variability
#6
Pau Herrero, Jorge Bondia, Oloruntoba Adewuyi, Peter Pesl, Mohamed El-Sharkawy, Monika Reddy, Chris Toumazou, Nick Oliver, Pantelis Georgiou
BACKGROUND AND OBJECTIVE: Current prototypes of closed-loop systems for glucose control in type 1 diabetes mellitus, also referred to as artificial pancreas systems, require a pre-meal insulin bolus to compensate for delays in subcutaneous insulin absorption in order to avoid initial post-prandial hyperglycemia. Computing such a meal bolus is a challenging task due to the high intra-subject variability of insulin requirements. Most closed-loop systems compute this pre-meal insulin dose by a standard bolus calculation, as is commonly found in insulin pumps...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28679886/the-artificial-pancreas-reducing-safety-risk-via-intra-peritoneal-insulin-delivery
#7
Richard W Jones, Francesco Gianni, Georgios Despotou, Konstantinos Katzis
The Artificial Pancreas is a medical device, currently in development, that aims to provide automatic regulation of blood glucose (BG) levels in ambulatory type 1 diabetes mellitus sufferers. The most popular approach utilises subcutaneous (SC) continuous glucose monitoring (CGM) combined with SC insulin injection controlled by a Model Predictive Control (MPC) algorithm. From a safety risk perspective problematic elements include the performance robustness of the CGM and the need for a pre-meal insulin bolus to provide satisfactory post prandial BG regulation...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28675686/the-challenges-of-achieving-postprandial-glucose-control-using-closed-loop-systems-in-patients-with-type-1-diabetes
#8
REVIEW
Véronique Gingras, Nadine Taleb, Amélie Roy-Fleming, Laurent Legault, Rémi Rabasa-Lhoret
For patients with type 1 diabetes, closed-loop delivery systems (CLS) combining an insulin pump, a glucose sensor and a dosing algorithm allowing a dynamic hormonal infusion have been shown to improve glucose control when compared to conventional therapy. Yet, reducing glucose excursion as well as simplification of prandial insulin doses remains a challenge. The objective of this literature review is to examine current meal-time strategies in the context of automated delivery systems in adults and children with type 1 diabetes...
July 4, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28654314/cross-validation-of-a-glucose-insulin-glucagon-pharmacodynamics-model-for-simulation-using-data-from-patients-with-type-1-diabetes
#9
Sabrina Lyngbye Wendt, Ajenthen Ranjan, Jan Kloppenborg Møller, Signe Schmidt, Carsten Boye Knudsen, Jens Juul Holst, Sten Madsbad, Henrik Madsen, Kirsten Nørgaard, John Bagterp Jørgensen
BACKGROUND: Currently, no consensus exists on a model describing endogenous glucose production (EGP) as a function of glucagon concentrations. Reliable simulations to determine the glucagon dose preventing or treating hypoglycemia or to tune a dual-hormone artificial pancreas control algorithm need a validated glucoregulatory model including the effect of glucagon. METHODS: Eight type 1 diabetes (T1D) patients each received a subcutaneous (SC) bolus of insulin on four study days to induce mild hypoglycemia followed by a SC bolus of saline or 100, 200, or 300 µg of glucagon...
February 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28626906/behavioural-implications-of-traditional-treatment-and-closed-loop-automated-insulin-delivery-systems-in-type-1-diabetes-applying-a-cognitive-restraint-theory-framework
#10
REVIEW
A R Kahkoska, E J Mayer-Davis, K K Hood, D M Maahs, K S Burger
As the prevalence of obesity in Type 1 diabetes rises, the effects of emerging therapy options should be considered in the context of both weight and glycaemic control outcomes. Artificial pancreas device systems will 'close the loop' between blood glucose monitoring and automated insulin delivery and may transform day-to-day dietary management for people with Type 1 diabetes in multiple ways. In the present review, we draw directly from cognitive restraint theory to consider unintended impacts that closed-loop systems may have on ingestive behaviour and food intake...
June 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28626803/estimation-of-insulin-secretion-glucose-uptake-by-tissues-and-liver-handling-of-glucose-using-a-mathematical-model-of-glucose-insulin-homeostasis-in-lean-and-obese-mice
#11
Michael Brenner, Sakineh Esmaeili Mohsen Abadi, Ramin Balouchzadeh, H Felix Lee, Hoo Sang Ko, Michael Johns, Nehal Malik, Joshua J Lee, Guim Kwon
Destruction of the insulin-producing β-cells is the key determinant of diabetes mellitus regardless of their types. Due to their anatomical location within the islets of Langerhans scattered throughout the pancreas, it is difficult to monitor β-cell function and mass clinically. To this end, we propose to use a mathematical model of glucose-insulin homeostasis to estimate insulin secretion, glucose uptake by tissues, and hepatic handling of glucose. We applied the mathematical model by Lombarte et al. (2013) to compare various rate constants representing glucose-insulin homeostasis between lean (11% fat)- and high fat diet (HFD; 45% fat)-fed mice...
June 2017: Heliyon
https://www.readbyqxmd.com/read/28613949/importance-of-artificial-pancreas-standard-nomenclature
#12
Ananda Basu
No abstract text is available yet for this article.
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28613947/the-effects-of-basal-insulin-suspension-at-the-start-of-exercise-on-blood-glucose-levels-during-continuous-versus-circuit-based-exercise-in-individuals-with-type-1-diabetes-on-continuous-subcutaneous-insulin-infusion
#13
Dessi Zaharieva, Loren Yavelberg, Veronica Jamnik, Ali Cinar, Kamuran Turksoy, Michael C Riddell
BACKGROUND: Exercise causes glycemic disturbances in individuals with type 1 diabetes (T1D). Continuous moderate-intensity aerobic exercise (CON) generally lowers blood glucose (BG) levels and often leads to hypoglycemia. In comparison, circuit-based exercise (CIRC) may attenuate the drop in BG. The goal of this study is to contrast the effects of basal insulin suspension at the onset of two different forms of exercise (CON vs. CIRC). METHODS: Twelve individuals (six men and six women) with T1D on insulin pump therapy were recruited for the study...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28604634/modeling-the-error-of-the-medtronic-paradigm-veo-enlite-glucose-sensor
#14
Lyvia Biagi, Charrise M Ramkissoon, Andrea Facchinetti, Yenny Leal, Josep Vehi
Continuous glucose monitors (CGMs) are prone to inaccuracy due to time lags, sensor drift, calibration errors, and measurement noise. The aim of this study is to derive the model of the error of the second generation Medtronic Paradigm Veo Enlite (ENL) sensor and compare it with the Dexcom SEVEN PLUS (7P), G4 PLATINUM (G4P), and advanced G4 for Artificial Pancreas studies (G4AP) systems. An enhanced methodology to a previously employed technique was utilized to dissect the sensor error into several components...
June 12, 2017: Sensors
https://www.readbyqxmd.com/read/28585873/a-simple-composite-metric-for-the-assessment-of-glycemic-status-from-continuous-glucose-monitoring-data-implications-for-clinical-practice-and-the-artificial-pancreas
#15
Irl B Hirsch, Andrew K Balo, Kevin Sayer, Arturo Garcia, Bruce A Buckingham, Thomas A Peyser
BACKGROUND: The potential clinical benefits of continuous glucose monitoring (CGM) have been recognized for many years, but CGM is used by a small fraction of patients with diabetes. One obstacle to greater use of the technology is the lack of simplified tools for assessing glycemic control from CGM data without complicated visual displays of data. METHODS: We developed a simple new metric, the personal glycemic state (PGS), to assess glycemic control solely from continuous glucose monitoring data...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28584075/application-of-zone-model-predictive-control-artificial-pancreas-during-extended-use-of-infusion-set-and-sensor-a-randomized-crossover-controlled-home-use-trial
#16
Gregory P Forlenza, Sunil Deshpande, Trang T Ly, Daniel P Howsmon, Faye Cameron, Nihat Baysal, Eric Mauritzen, Tatiana Marcal, Lindsey Towers, B Wayne Bequette, Lauren M Huyett, Jordan E Pinsker, Ravi Gondhalekar, Francis J Doyle, David M Maahs, Bruce A Buckingham, Eyal Dassau
OBJECTIVE: As artificial pancreas (AP) becomes standard of care, consideration of extended use of insulin infusion sets (IIS) and continuous glucose monitors (CGMs) becomes vital. We conducted an outpatient randomized crossover study to test the safety and efficacy of a zone model predictive control (zone-MPC)-based AP system versus sensor augmented pump (SAP) therapy in which IIS and CGM failures were provoked via extended wear to 7 and 21 days, respectively. RESEARCH DESIGN AND METHODS: A smartphone-based AP system was used by 19 adults (median age 23 years [IQR 10], mean 8...
August 2017: Diabetes Care
https://www.readbyqxmd.com/read/28541890/event-triggered-model-predictive-control-for-embedded-artificial-pancreas-systems
#17
Ankush Chakrabarty, Stamatina Zavitsanou, Francis Doyle Iii, Eyal Dassau
OBJECTIVE: The development of artificial pancreas (AP) technology for deployment in low-energy, embedded devices is contingent upon selecting an efficient control algorithm for regulating glucose in people with type 1 diabetes mellitus (T1DM). In this paper, we aim to lower the energy consumption of the AP by reducing controller updates, that is, the number of times the decision-making algorithm is invoked to compute an appropriate insulin dose. METHODS: Physiological insights into glucose management are leveraged to design an event-triggered model predictive controller (MPC) that operates efficiently, without compromising patient safety...
May 23, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28533139/artificial-pancreas-research-you-can-observe-a-lot-by-watching
#18
Steven J Russell
No abstract text is available yet for this article.
May 19, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28533136/effect-of-artificial-pancreas-systems-on-glycaemic-control-in-patients-with-type-1-diabetes-a-systematic-review-and-meta-analysis-of-outpatient-randomised-controlled-trials
#19
Alanna Weisman, Johnny-Wei Bai, Marina Cardinez, Caroline K Kramer, Bruce A Perkins
BACKGROUND: Closed-loop artificial pancreas systems have been in development for several years, including assessment in numerous varied outpatient clinical trials. We aimed to summarise the efficacy and safety of artificial pancreas systems in outpatient settings and explore the clinical and technical factors that can affect their performance. METHODS: We did a systematic review and meta-analysis of randomised controlled trials comparing artificial pancreas systems (insulin only or insulin plus glucagon) with conventional pump therapy (continuous subcutaneous insulin infusion [CSII] with blinded continuous glucose monitoring [CGM] or unblinded sensor-augmented pump [SAP] therapy) in adults and children with type 1 diabetes...
July 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28532321/-210-polonium-bioaccessibility-assessment-in-algae-for-human-consumption-an-in-vitro-gastrointestinal-digestion-method
#20
Donatella Desideri, Maria Assunta Meli, Carla Roselli, Laura Feduzi, Lucia Ugolini
The occurrence and mobility of natural radioactive element as (210)Polonium ((210)Po) in 13 commercial algae consumed in Italy by humans were determined because the effects on human health need to take into account the bioavailability of these elements. The simulation of gastrointestinal (GIT) digestion was divided into three stages and was accomplished using three different artificial solutions: saliva, gastric, and synthetic bile-pancreas solution. The same sample was treated in two different ways: a) only gastric digestion and b) complete GIT digestion (gastric digestion followed by bile-pancreas solution)...
2017: Journal of Toxicology and Environmental Health. Part A
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