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Artificial pancreas

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
June 5, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28541890/event-triggered-model-predictive-control-for-embedded-artificial-pancreas-systems
#9
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
#10
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
#11
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...
May 19, 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
#12
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)...
May 22, 2017: Journal of Toxicology and Environmental Health. Part A
https://www.readbyqxmd.com/read/28520531/artificial-pancreas-in-young-children
#13
Rebecca A Ohman-Hanson, Gregory P Forlenza
No abstract text is available yet for this article.
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28509784/pharmacotherapy-options-for-pediatric-diabetes
#14
Maria Loredana Marcovecchio, Francesco Chiarelli
PURPOSE OF REVIEW: Type 1 diabetes (T1D) and type 2 diabetes (T2D) are frequent conditions during childhood and adolescence. The present review offers an update on current available treatment strategies for T1D and T2D approved for use in children and adolescents. RECENT FINDINGS: Insulin remains the main and essential therapeutic strategy in youth with T1D. A second generation of insulin analogues is being evaluated and could help in improving glycemic control...
May 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28503717/a-review-of-the-current-challenges-associated-with-the-development-of-an-artificial-pancreas-by-a-double-subcutaneous-approach
#15
REVIEW
Sverre Christian Christiansen, Anders Lyngvi Fougner, Øyvind Stavdahl, Konstanze Kölle, Reinold Ellingsen, Sven Magnus Carlsen
INTRODUCTION: Patients with diabetes type 1 (DM1) struggle daily to achieve good glucose control. The last decade has seen a rush of research groups working towards an artificial pancreas (AP) through the application of a double subcutaneous approach, i.e., subcutaneous (SC) continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion. Few have focused on the fundamental limitations of this approach, especially regarding outcome measures beyond time in range. METHODS: Based on insulin physiology, the limitations of CGM, SC insulin absorption, meal challenge, and physical activity in DM1 patients, we discuss the limitations of the double SC approach...
June 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28495545/asymptotic-tracking-and-disturbance-rejection-of-the-blood-glucose-regulation-system
#16
Brandon Ashley, Weijiu Liu
Type 1 diabetes patients need external insulin to maintain blood glucose within a narrow range from 65 to 108 mg/dl (3.6 to 6.0 mmol/l). A mathematical model for the blood glucose regulation is required for integrating a glucose monitoring system into insulin pump technology to form a closed-loop insulin delivery system on the feedback of the blood glucose, the so-called "artificial pancreas". The objective of this paper is to treat the exogenous glucose from food as a glucose disturbance and then develop a closed-loop feedback and feedforward control system for the blood glucose regulation system subject to the exogenous glucose disturbance...
May 8, 2017: Mathematical Biosciences
https://www.readbyqxmd.com/read/28474383/intraperitoneal-insulin-delivery-provides-superior-glycemic-regulation-to-subcutaneous-insulin-delivery-in-model-predictive-control-based-fully-automated-artificial-pancreas-in-patients-with-type-1-diabetes-a-pilot-study
#17
Eyal Dassau, Eric Renard, Jérôme Place, Anne Farret, Marie-José Pelletier, Justin Lee, Lauren M Huyett, Ankush Chakrabarty, Francis J Doyle, Howard C Zisser
AIMS: To compare intraperitoneal (IP) to subcutaneous (SC) insulin delivery in an artificial pancreas (AP). MATERIALS AND METHODS: Ten adults with type 1 diabetes participated in a non-randomized, non-blinded sequential AP study using the same SC glucose sensing and Zone Model Predictive Control (ZMPC) algorithm adjusted for insulin clearance. On first admission, subjects underwent closed-loop control with SC delivery of a fast-acting insulin analogue for 24 hr...
May 5, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28459617/outpatient-closed-loop-control-with-unannounced-moderate-exercise-in-adolescents-using-zone-model-predictive-control
#18
Lauren M Huyett, Trang T Ly, Gregory P Forlenza, Suzette Reuschel-DiVirgilio, Laurel H Messer, R Paul Wadwa, Ravi Gondhalekar, Francis J Doyle, Jordan E Pinsker, David M Maahs, Bruce A Buckingham, Eyal Dassau
BACKGROUND: The artificial pancreas (AP) has the potential to improve glycemic control in adolescents. This article presents the first evaluation in adolescents of the Zone Model Predictive Control and Health Monitoring System (ZMPC+HMS) AP algorithms, and their first evaluation in a supervised outpatient setting with frequent exercise. MATERIALS AND METHODS: Adolescents with type 1 diabetes underwent 3 days of closed-loop control (CLC) in a hotel setting with the ZMPC+HMS algorithms on the Diabetes Assistant platform...
June 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28439847/the-role-of-the-fda-and-regulatory-approval-of-new-devices-for-diabetes-care
#19
REVIEW
Shelley A Jazowski, Aaron N Winn
PURPOSE OF REVIEW: The Food and Drug Administration (FDA) is responsible for assuring the safety, effectiveness, and quality of medical devices in the USA. Extensive review times coupled with the demand for necessary treatments have prompted the policymakers to implement measures to speed medical devices to market.The purpose of this review is to summarize the evolution of the regulatory pathways through which medical devices utilized in diabetes care gain market access. RECENT FINDINGS: Regulatory pathways, ranging from premarket notification to premarket approval, require distinct, yet necessary ("least burdensome") evidence demonstrating a device's safety and effectiveness...
June 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28427321/in-silico-assessment-of-biomedical-products-the-conundrum-of-rare-but-not-so-rare-events-in-two-case-studies
#20
Marco Viceconti, Claudio Cobelli, Tarek Haddad, Adam Himes, Boris Kovatchev, Mark Palmer
In silico clinical trials, defined as "The use of individualized computer simulation in the development or regulatory evaluation of a medicinal product, medical device, or medical intervention," have been proposed as a possible strategy to reduce the regulatory costs of innovation and the time to market for biomedical products. We review some of the the literature on this topic, focusing in particular on those applications where the current practice is recognized as inadequate, as for example, the detection of unexpected severe adverse events too rare to be detected in a clinical trial, but still likely enough to be of concern...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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