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Artificial pancreas

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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
#1
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
https://www.readbyqxmd.com/read/28426239/performance-of-an-artificial-pancreas-system-for-young-children-with-type-1-diabetes
#2
Mark D DeBoer, Marc D Breton, Christian Wakeman, Elaine M Schertz, Emma G Emory, Jessica L Robic, Laura L Kollar, Boris P Kovatchev, Daniel R Cherñavvsky
BACKGROUND: Young children 5-8 years old with type 1 diabetes (T1D) exhibit clear needs for improved glycemic control but may be limited in their ability to safely interact with an artificial pancreas system. Our goal was to evaluate the safety and performance of an artificial pancreas (AP) system among young children with T1D. RESEARCH DESIGN AND METHODS: In a randomized, crossover trial, children with T1D age 5-8 years were enrolled to receive on separate study periods (in random order) either the UVa AP using the DiAs Control Platform software with child-resistant lock-out screens (followed as an out-patient admission) or their usual insulin pump+continuous glucose monitor (CGM) care at home...
April 20, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28418732/insulin-infusion-sets-and-continuous-glucose-monitoring-sensors-where-the-artificial-pancreas-meets-the-patient
#3
Gregory P Forlenza
No abstract text is available yet for this article.
April 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28388308/identification-of-type-iii-interferon-ifn-%C3%AE-in-chinese-goose-gene-structure-age-dependent-expression-profile-and-antiviral-immune-characteristics-in-vivo-and-in-vitro
#4
Qin Zhou, Wei Zhang, Shun Chen, Anqi Wang, Lipei Sun, Mingshu Wang, Renyong Jia, Dekang Zhu, Mafeng Liu, Kunfeng Sun, Qiao Yang, Ying Wu, Xiaoyue Chen, Anchun Cheng
Type III interferons (IFN-λ1/λ2/λ3, also known as IL-29/28A/28B, and IFN-λ4) are a recently discovered interferon group. In this study, we first identified the Chinese goose IFN-λ (goIFN-λ). The full-length sequence of goIFN-λ was found to be 823 bp. There was only one open reading frame that contained 570 bp, and, encoded 189 amino acids. The predicted goIFN-λ protein showed 78%, 67%, and 40% amino acid identity with duIFN-λ, chIFN-λ, and hIFN-λ3, respectively. The tissue distribution of goIFN-λ existed as a parallel distribution with goIFNLR1 as its functional receptor, which was mainly expressed in epithelium-rich tissues, such as lung, gizzard, proventriculus, skin and pancreas, and immune tissues, such as harderian gland and thymus...
April 7, 2017: Journal of Interferon & Cytokine Research
https://www.readbyqxmd.com/read/28366258/-the-artificial-pancreas-a-dream-on-the-point-of-becoming-reality
#5
REVIEW
Éric Renard, Jérôme Place, Najib Benbrahim, Omar Diouri, Anne Farret
Almost 45 000 patients with type 1 diabetes are concerned in France by outpatient insulin pump therapy. The first systems of insulin pump therapy guided by glycaemia have evolved driven by the work carried out by multi-disciplinary research teams. Today, the outpatient treatment of type 1 diabetes by an artificial pancreas is on the point of becoming reality.
April 2017: Revue de L'infirmière
https://www.readbyqxmd.com/read/28361610/an-industry-update-the-latest-developments-in-therapeutic-delivery
#6
Oliver C Steinbach
The present industry update covers the period 1-31 January 2017, with information sourced from company press releases, regulatory and patent agencies as well as the scientific literature. With a new year come new resolutions, annual operation plans but also reports and outlooks for the years(s) to come. A number of the latter have been published in January forecasting various spaces in drug delivery (Market and Research). Also a number of financing deals were closed being fresh into the year such as Ossianix and Ocular Therapeutix and contract manufacturers will show their offerings at the 2017 MD&M West Medtech event (Lubrizol, Trelleborg)...
March 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28349709/meeting-report
#7
Barry H Ginsberg, David C Klonoff, Vincent P Crabtree
On July 6 and 7, 2016 the Fourth Artificial Pancreas Workshop: Testing and Adoption of Current and Emerging Technologies was held on the National Institutes of Health (NIH) Campus at the Lister Hill Auditorium. The meeting was sponsored by a group of governmental organizations and NGOs, listed in Appendix A. This was a very timely meeting as the artificial pancreas appears to be growing from academic studies to commercial projects. The first artificial pancreas may be marketed within 12 months and a few may be approved within 24 months...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28340542/expectations-and-attitudes-of-individuals-with-type-1-diabetes-after-using-a-hybrid-closed-loop-system
#8
Esti Iturralde, Molly L Tanenbaum, Sarah J Hanes, Sakinah C Suttiratana, Jodie M Ambrosino, Trang T Ly, David M Maahs, Diana Naranjo, Natalie Walders-Abramson, Stuart A Weinzimer, Bruce A Buckingham, Korey K Hood
Purpose The first hybrid closed loop (HCL) system, which automates insulin delivery but requires user inputs, was approved for treatment of type 1 diabetes (T1D) by the US Food and Drug Administration in September 2016. The purpose of this study was to explore the benefits, expectations, and attitudes of individuals with T1D following a clinical trial of an HCL system. Methods Thirty-two individuals with T1D (17 adults, 15 adolescents) participated in focus groups after 4 to 5 days of system use. Content analysis generated themes regarding perceived benefits, hassles, and limitations...
April 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28324962/design-of-a-dual-hormone-model-predictive-control-for-artificial-pancreas-with-exercise-model
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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...
May 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28245784/closing-the-loop-on-exercise-in-type-1-diabetes
#17
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
#18
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
#19
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
#20
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
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