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Artificial pancreas

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https://www.readbyqxmd.com/read/28324962/design-of-a-dual-hormone-model-predictive-control-for-artificial-pancreas-with-exercise-model
#1
Navid Resalat, Joseph El Youssef, Ravi Reddy, Peter G Jacobs
The Artificial Pancreas (AP) is a new technology for helping people with type 1 diabetes to better control their glucose levels through automated delivery of insulin and optionally glucagon in response to sensed glucose levels. In a dual hormone AP, insulin and glucagon are delivered automatically to the body based on glucose sensor measurements using a control algorithm that calculates the amount of hormones to be infused. A dual-hormone MPC may deliver insulin continuously; however, it must avoid continuous delivery of glucagon because nausea can occur from too much glucagon...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#2
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28304392/metrics-for-glycaemic-control-from-hba1c-to-continuous-glucose-monitoring
#3
REVIEW
Boris P Kovatchev
As intensive treatment to lower levels of HbA1c characteristically results in an increased risk of hypoglycaemia, patients with diabetes mellitus face a life-long optimization problem to reduce average levels of glycaemia and postprandial hyperglycaemia while simultaneously avoiding hypoglycaemia. This optimization can only be achieved in the context of lowering glucose variability. In this Review, I discuss topics that are related to the assessment, quantification and optimal control of glucose fluctuations in diabetes mellitus...
March 17, 2017: Nature Reviews. Endocrinology
https://www.readbyqxmd.com/read/28278487/meal-detection-and-carbohydrate-estimation-using-continuous-glucose-sensor-data
#4
Sediqeh Samadi, Kamuran Turksoy, Iman Hajizadeh, Jianyuan Feng, Mert Sevil, Ali Cinar
A meal detection and meal size estimation algorithm is developed for use in artificial pancreas (AP) control systems for people with type 1 diabetes. The algorithm detects the consumption of a meal and estimates its carbohydrate (CHO) amount to determine the appropriate dose of insulin bolus for a meal. It can be used in AP systems without manual meal announcements, or as a safety feature for people who may forget entering meal information manually. Using qualitative representation of the filtered continuous glucose monitor signal, a time period labeled as meal flag is identified...
March 3, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28272368/use-of-wearable-sensors-and-biometric-variables-in-an-artificial-pancreas-system
#5
Kamuran Turksoy, Colleen Monforti, Minsun Park, Garett Griffith, Laurie Quinn, Ali Cinar
An artificial pancreas (AP) computes the optimal insulin dose to be infused through an insulin pump in people with Type 1 Diabetes (T1D) based on information received from a continuous glucose monitoring (CGM) sensor. It has been recognized that exercise is a major challenge in the development of an AP system. The use of biometric physiological variables in an AP system may be beneficial for prevention of exercise-induced challenges and better glucose regulation. The goal of the present study is to find a correlation between biometric variables such as heart rate (HR), heat flux (HF), skin temperature (ST), near-body temperature (NBT), galvanic skin response (GSR), and energy expenditure (EE), 2D acceleration-mean of absolute difference (MAD) and changes in glucose concentrations during exercise via partial least squares (PLS) regression and variable importance in projection (VIP) in order to determine which variables would be most useful to include in a future artificial pancreas...
March 7, 2017: Sensors
https://www.readbyqxmd.com/read/28268592/a-multiscale-model-based-analysis-of-the-multi-tissue-interplay-underlying-blood-glucose-regulation-in-type-i-diabetes
#6
Federico Wadehn, Stephan Schaller, Thomas Eissing, Markus Krauss, Lars Kupfer
A multiscale model for blood glucose regulation in diabetes type I patients is constructed by integrating detailed metabolic network models for fat, liver and muscle cells into a whole body physiologically-based pharmacokinetic/pharmacodynamic (pBPK/PD) model. The blood glucose regulation PBPK/PD model simulates the distribution and metabolization of glucose, insulin and glucagon on an organ and whole body level. The genome-scale metabolic networks in contrast describe intracellular reactions. The developed multiscale model is fitted to insulin, glucagon and glucose measurements of a 48h clinical trial featuring 6 subjects and is subsequently used to simulate (in silico) the influence of geneknockouts and drug-induced enzyme inhibitions on whole body blood glucose levels...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28264192/moving-toward-a-unified-platform-for-insulin-delivery-and-sensing-of-inputs-relevant-to-an-artificial-pancreas
#7
Anneke Graf, Sybil A McAuley, Catriona Sims, Johanna Ulloa, Alicia J Jenkins, Gayane Voskanyan, David N O'Neal
Advances in insulin pump and continuous glucose monitoring technology have primarily focused on optimizing glycemic control for people with type 1 diabetes. There remains a need to identify ways to minimize the physical burden of this technology. A unified platform with closely positioned or colocalized interstitial fluid glucose sensing and hormone delivery components is a potential solution. Present challenges to combining these components are interference of glucose sensing from proximate insulin delivery and the large discrepancy between the life span of current insulin infusion sets and glucose sensors...
March 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28254450/diabetic-phenotype-of-transgenic-pigs-introduced-by-dominant-negative-mutant-hepatocyte-nuclear-factor-1%C3%AE
#8
Kazuhiro Umeyama, Masami Nakajima, Takashi Yokoo, Masaki Nagaya, Hiroshi Nagashima
AIM: The present study aimed to identify the characteristics of genetically modified pigs carrying a mutant human gene as a research model for diabetes and its complications. METHODS: We developed a transgenic cloned pig (founder, male) carrying a mutant gene, i.e., human HNF-1α (P291fsinsC), which is responsible for maturity-onset diabetes of the young type 3. Transgenic progeny obtained via the artificial insemination of wild type (WT) sows with the cryopreserved sperm derived from the founder pig was pathologically examined...
February 13, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28245784/closing-the-loop-on-exercise-in-type-1-diabetes
#9
Lia Bally, Hood Thabit
BACKGROUND: Despite its well-established health benefits, exercise imposes challenges on glucose control in individuals with type 1 diabetes due to to the complex interactions between exercise-induced effects on glucose metabolism and exogenous insulin therapy. Although clinical guidelines for exercise management in type 1 diabetes are available, implementation is challenging in daily -life. The risk of exercise-induced dysglycaemia deters many people with type 1 diabetes from participating and benefiting from exercise...
February 28, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28226972/design-of-a-dual-hormone-model-predictive-control-for-artificial-pancreas-with-exercise-model
#10
Navid Resalat, Joseph El Youssef, Ravi Reddy, Peter G Jacobs, Navid Resalat, Joseph El Youssef, Ravi Reddy, Peter G Jacobs, Navid Resalat, Joseph El Youssef, Peter G Jacobs, Ravi Reddy
The Artificial Pancreas (AP) is a new technology for helping people with type 1 diabetes to better control their glucose levels through automated delivery of insulin and optionally glucagon in response to sensed glucose levels. In a dual hormone AP, insulin and glucagon are delivered automatically to the body based on glucose sensor measurements using a control algorithm that calculates the amount of hormones to be infused. A dual-hormone MPC may deliver insulin continuously; however, it must avoid continuous delivery of glucagon because nausea can occur from too much glucagon...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226770/a-multiscale-model-based-analysis-of-the-multi-tissue-interplay-underlying-blood-glucose-regulation-in-type-i-diabetes
#11
Federico Wadehn, Stephan Schaller, Thomas Eissing, Markus Krauss, Lars Kupfer, Federico Wadehn, Stephan Schaller, Thomas Eissing, Markus Krauss, Lars Kupfer, Federico Wadehn, Markus Krauss, Lars Kupfer, Stephan Schaller, Thomas Eissing
A multiscale model for blood glucose regulation in diabetes type I patients is constructed by integrating detailed metabolic network models for fat, liver and muscle cells into a whole body physiologically-based pharmacokinetic/pharmacodynamic (pBPK/PD) model. The blood glucose regulation PBPK/PD model simulates the distribution and metabolization of glucose, insulin and glucagon on an organ and whole body level. The genome-scale metabolic networks in contrast describe intracellular reactions. The developed multiscale model is fitted to insulin, glucagon and glucose measurements of a 48h clinical trial featuring 6 subjects and is subsequently used to simulate (in silico) the influence of geneknockouts and drug-induced enzyme inhibitions on whole body blood glucose levels...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28114938/closed-loop-for-type-1-diabetes-an-introduction-and-appraisal-for-the-generalist
#12
EDITORIAL
Lia Bally, Hood Thabit, Roman Hovorka
BACKGROUND: Rapid progress over the past decade has been made with the development of the 'Artificial Pancreas', also known as the closed-loop system, which emulates the feedback glucose-responsive functionality of the pancreatic beta cell. The recent FDA approval of the first hybrid closed-loop system makes the Artificial Pancreas a realistic therapeutic option for people with type 1 diabetes. In anticipation of its advent into clinical care, we provide a primer and appraisal of this novel therapeutic approach in type 1 diabetes for healthcare professionals and non-specialists in the field...
January 23, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28098839/continuous-glucose-monitoring-enables-the-detection-of-losses-in-infusion-set-actuation-lisas
#13
Daniel P Howsmon, Faye Cameron, Nihat Baysal, Trang T Ly, Gregory P Forlenza, David M Maahs, Bruce A Buckingham, Juergen Hahn, B Wayne Bequette
Reliable continuous glucose monitoring (CGM) enables a variety of advanced technology for the treatment of type 1 diabetes. In addition to artificial pancreas algorithms that use CGM to automate continuous subcutaneous insulin infusion (CSII), CGM can also inform fault detection algorithms that alert patients to problems in CGM or CSII. Losses in infusion set actuation (LISAs) can adversely affect clinical outcomes, resulting in hyperglycemia due to impaired insulin delivery. Prolonged hyperglycemia may lead to diabetic ketoacidosis-a serious metabolic complication in type 1 diabetes...
January 15, 2017: Sensors
https://www.readbyqxmd.com/read/28097553/-pumps-sensors-and-the-dream-of-the-artificial-pancreas-a-clinical-update-to-modern-technologies-in-diabetes
#14
REVIEW
Bernhard Gehr
No abstract text is available yet for this article.
January 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28094472/outpatient-60-hour%C3%A2-day-and-night%C3%A2-glucose-control-with-dual-hormone%C3%A2-artificial-pancreas-single-hormone-artificial-pancreas-%C3%A2-or-sensor-augmented-pump-therapy-in-adults-with%C3%A2-type-1-diabetes-an-open-label-%C3%A2-randomised-crossover-controlled-trial
#15
Ahmad Haidar, Virginie Messier, Laurent Legault, Martin Ladouceur, Rémi Rabasa-Lhoret
AIMS: To assess whether the dual-hormone (insulin and glucagon) artificial pancreas reduces hypoglycemia compared to the single-hormone (insulin alone) artificial pancreas in outpatient settings during the day and night. MATERIAL AND METHODS: In a randomized, three-way, crossover trial, we compared the dual-hormone artificial pancreas, the single-hormone artificial pancreas, and sensor-augmented pump therapy (control) in 23 adults with type 1 diabetes. Each intervention was applied from 08 h00 Day 1 to 20 h00 Day 3 (60 hours) in outpatient free-living conditions...
January 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28094137/the-artificial-pancreas-ready-for-prime-time
#16
J Hans DeVries
No abstract text is available yet for this article.
January 13, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28092515/towards-a-run-to-run-adaptive-artificial-pancreas-in-silico-results
#17
Chiara Toffanin, Roberto Visentin, Mirko Messori, Federico Di Palma, Lalo Magni, Claudio Cobelli
Contemporary and future outpatient long-term artificial pancreas (AP) studies need to cope with the well-known large intra- and inter-day 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...
January 11, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28060528/-learning-can-improve-the-blood-glucose-control-performance-for-type-1-diabetes-mellitus
#18
Youqing Wang, Jinping Zhang, Fanmao Zeng, Na Wang, Xiaoping Chen, Bo Zhang, Dong Zhao, Wenying Yang, Claudio Cobelli
BACKGROUND: A learning-type artificial pancreas has been proposed to exploit the repetitive nature in the blood glucose dynamics. We clinically evaluated the efficacy of the learning-type artificial pancreas. METHODS: We conducted a pilot clinical study in 10 participants of mean age 36.1 years (standard deviation [SD] 12.7; range 16-58) with type 1 diabetes. Each trial was conducted for eight consecutive mornings. The first two mornings were open-loop to obtain the individualized parameters...
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28055224/in-home-closed-loop-control-for-artificial-pancreas-patient-and-provider-perspective
#19
Laya Ekhlaspour, David M Maahs
No abstract text is available yet for this article.
January 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/27982707/feasibility-of-long-term-closed-loop-control-a-multicenter-6-month-trial-of-24-7-automated-insulin-delivery
#20
Boris Kovatchev, Peiyao Cheng, Stacey M Anderson, Jordan E Pinsker, Federico Boscari, Bruce A Buckingham, Francis J Doyle, Korey K Hood, Sue A Brown, Marc D Breton, Daniel Chernavvsky, Wendy C Bevier, Paige K Bradley, Daniela Bruttomesso, Simone Del Favero, Roberta Calore, Claudio Cobelli, Angelo Avogaro, Trang T Ly, Satya Shanmugham, Eyal Dassau, Craig Kollman, John W Lum, Roy W Beck
BACKGROUND: In the past few years, the artificial pancreas-the commonly accepted term for closed-loop control (CLC) of blood glucose in diabetes-has become a hot topic in research and technology development. In the summer of 2014, we initiated a 6-month trial evaluating the safety of 24/7 CLC during free-living conditions. RESEARCH DESIGN AND METHODS: Following an initial 1-month Phase 1, 14 individuals (10 males/4 females) with type 1 diabetes at three clinical centers in the United States and one in Italy continued with a 5-month Phase 2, which included 24/7 CLC using the wireless portable Diabetes Assistant (DiAs) developed at the University of Virginia Center for Diabetes Technology...
January 2017: Diabetes Technology & Therapeutics
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