| An advisory protocol for rapid- and slow-acting insulin therapy based on a run-to-run methodology. | |
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MedLine Citation:
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PMID: 20597831 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Emerging technology, such as an artificial pancreatic beta-cell, is not likely to be affordable to people who live in developing nations in the next 20-30 years. However, multiple-daily injection (MDI) therapy can be improved using similar advanced control algorithms designed for continuous glucose monitoring and continuous insulin infusion pumps. METHODS: A simulation study of run-to-run control was developed for MDI therapy. Rapid- and slow-acting insulins were used in the protocol, which uses pre- and postprandial glucose measurements. The key information for the synthesis of the control algorithm is the subject insulin sensitivity that is calculated for two cases: (a) when the subject's glycemia and insulin dosing information is known (sensitivity response) and (b) when there is no previous information about the subject's response to the insulin protocol. In the latter case, this information needs to be estimated recursively using online data. After the sensitivity is recalculated, the run-to-run correction scheme is updated, obtaining an adaptive MDI therapy. The robustness of the advisory algorithm was evaluated by constant random parameter variations and superimposing sinusoidal oscillations on glucose-insulin model parameters to simulate intra-individual variability of the glucoregulatory system. RESULTS: Optimal glycemic control has been achieved for both cases (a and b) despite variable meals (15% variation in carbohydrate content and 15-min variation in timing) and parametric variations in the glucose-insulin model. In Case (b), no profound hypoglycemic (<60 mg/dL) or hyperglycemic (>180 mg/dL) events were observed on average during all evaluations. CONCLUSIONS: This work shows that the run-to-run framework for insulin updating can be successfully extended to an adaptive MDI protocol. These results motivate the practical implementation of this scheme in portable units such as personal digital assistants or smartphones. |
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Authors:
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Fabiola Campos-Cornejo; Daniel U Campos-Delgado; Diego Espinoza-Trejo; Howard Zisser; Lois Jovanovic; Francis J Doyle; Eyal Dassau |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diabetes technology & therapeutics Volume: 12 ISSN: 1557-8593 ISO Abbreviation: Diabetes Technol. Ther. Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-05 Completed Date: 2010-11-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100889084 Medline TA: Diabetes Technol Ther Country: United States |
Other Details:
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Languages: eng Pagination: 555-65 Citation Subset: IM |
Affiliation:
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Faculty of Engineering, Center for Research and Graduate Studies, Autonomous University of San Luis Potosí, San Luis Potosí, México. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms Blood Glucose / analysis Computer Simulation Diabetes Mellitus, Type 1 / blood, drug therapy*, immunology Humans Injections, Subcutaneous Insulin / administration & dosage, analogs & derivatives* Models, Immunological* |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/glargine; 11061-68-0/Insulin; 133107-64-9/insulin LISPRO |
| Comments/Corrections | |
Erratum In:
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Diabetes Technol Ther. 2010 Sep;12(9):747 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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