Explicitly Minimizing Clinical Risk Through Closed-loop Control of Blood Glucose in Patients with Type 1 Diabetes Mellitus
Title | Explicitly Minimizing Clinical Risk Through Closed-loop Control of Blood Glucose in Patients with Type 1 Diabetes Mellitus PDF eBook |
Author | Fraser Murray Coulter Cameron |
Publisher | |
Pages | |
Release | 2010 |
Genre | |
ISBN |
Type 1 Diabetes Mellitus or Juvenile Onset Diabetes is currently a permanent, incurable disease that removes the ability of the patient's body to control blood glucose levels. This loss of automatic control greatly increases the patient's exposure to clinical risks of high and low blood glucose levels. These risks can be mitigated through tight, regulation of blood glucose levels using insulin injections, but only at the price of paying frequent attention to the blood glucose levels and manually providing accurate dosing decisions. This can be very trying for all patients, especially teenagers and children. Recent technological advances enable automatic external regulation of patient's blood glucose levels. Pumps can infuse insulin into the subcutaneous tissue to lower blood glucose levels. Continuous glucose monitors can sense subcutaneous glucose levels, specifically the rises caused by meals and the drops caused by insulin. This has caused a flurry of control and modeling research, in the hopes of mitigating the clinical risk without the price of constant human attention. The most common approach, and the one taken here, is to use model predictive control, where the predictions from a model of glucose dynamics are optimized against a cost function using the future insulin injections. We directly minimize the asymmetric clinical risk instead, and recognize that our control authority (the potential effects of injecting insulin) is largely limited to reducing the blood glucose level. We further consider likely future blood glucose measurements, since we both respond better to positive disturbances than negative ones, and because negative disturbances are more risky. Also, we explicitly estimate the uncertainty of predictions, since glucose dynamics incorporate uncertainty from the complex biology, stochastic patient behaviour, and extrapolation. More uncertainty should mean more cautious insulin injection. Lastly, since meals occur faster than insulin acts and can raise the blood glucose by 2 to 4 times the width of the acceptable range, this work develops a novel Bayesian framework for detecting meals and estimating their effects. This work improves prediction root mean squared error by 20% relative to predictions excluding meals for prediction horizons from 1 to 4 hours and improves robustness to meals. These prediction improvements alone reduce the avoidable clinical risk by 38% relative to predictions excluding meals. When the improvements to the predictions are combined with minimizing clinical risk under uncertainty and measurement anticipation the avoidable clinical risk is reduced by 30% relative to a published MPC controller that has privileged information and tunes independently for each patient.
Closed-Loop Control of Blood Glucose
Title | Closed-Loop Control of Blood Glucose PDF eBook |
Author | Frederick Chee |
Publisher | Springer |
Pages | 167 |
Release | 2007-10-24 |
Genre | Technology & Engineering |
ISBN | 3540740317 |
This book presents closed-loop blood glucose control in a simple manner, which includes the hardware and "software" components that make up the control system. It provides examples on how mathematical models are formulated as well as the control algorithms that stem from mathematical exercises. The book also describes the basic physiology of blood glucose regulation during fasting and meal from a functional level.
The Artificial Pancreas
Title | The Artificial Pancreas PDF eBook |
Author | Ricardo S. Sánchez-Peña |
Publisher | Academic Press |
Pages | 306 |
Release | 2019-04-15 |
Genre | Science |
ISBN | 0128156562 |
The Artificial Pancreas: Current Situation and Future Directions presents research on the top issues relating to the artificial pancreas (AP) and its application to diabetes. AP is a newer form of treatment to accurately and efficiently inject insulin, thereby significantly improving the patient’s quality of life. By connecting a continuous glucose monitor (CGM) to a continuous subcutaneous insulin infusion using a control algorithm, AP delivers and regulates the most accurate amount of insulin to maintain normal glycemic values. Featured chapters in this book are written by world leaders in AP research, thus providing readers with the latest studies and results. Focuses on Type 1 Diabetes Mellitus (T1DM) that is primarily found in children and typically treated by means of a syringe or insulin pump Features research and results from top academic experimental groups, and from universities such as Harvard (USA), the University of Virginia (USA), the University of Padova (Italy), the University of Montpellier (France), and the Buenos Aires Institute of Technology (Argentina) Discusses clinical trials of AP from around the world, including the United States, the EU, Latin America, and Israel
Hypoglycemia in Diabetes
Title | Hypoglycemia in Diabetes PDF eBook |
Author | Philip Cryer |
Publisher | American Diabetes Association |
Pages | 194 |
Release | 2016-07-12 |
Genre | Medical |
ISBN | 1580406491 |
Intended for diabetes researchers and medical professionals who work closely with patients with diabetes, this newly updated and expanded edition provides new perspectives and direct insight into the causes and consequences of this serious medical condition from one of the foremost experts in the field. Using the latest scientific and medical developments and trends, readers will learn how to identify, prevent, and treat this challenging phenomenon within the parameters of the diabetes care regimen.
Runtime Verification
Title | Runtime Verification PDF eBook |
Author | Ezio Bartocci |
Publisher | Springer |
Pages | 439 |
Release | 2015-09-19 |
Genre | Computers |
ISBN | 3319238205 |
This book constitutes the refereed proceedings of the 6th International Conference on Runtime Verification, RV 2015, held in Vienna, Austria, in September 2015. The 15 revised full papers presented together with 4 short papers, 2 tool papers, 4 tutorials, 3 invited talks, and 2 software competition papers were carefully reviewed and selected from 45 submissions. The discussion of the conference centers around two main aspects. The first is to understand wether the runtime verification techniques can practically complement the traditional methods proving programs correct before their execution, such as model checking and theorem proving. The second concerns with formal methods and how their application can improve traditional ad-hoc monitoring techniques used in performance monitoring, hardware design emulation and simulation, etc.
Technological Advances in the Treatment of Type 1 Diabetes
Title | Technological Advances in the Treatment of Type 1 Diabetes PDF eBook |
Author | D. Bruttomesso |
Publisher | Karger Medical and Scientific Publishers |
Pages | 274 |
Release | 2014-11-17 |
Genre | Medical |
ISBN | 331802337X |
The current epidemic of diabetes, obesity and related disorders is a driving force in the development of new technologies. Technological advances offer great new opportunities for the treatment of these chronic diseases. This review presents an update of developments that promise to revolutionize the treatment of diabetes. It examines hospital and outpatient care, intensive insulin therapy, blood glucose monitoring and innovative steps towards the construction of an artificial pancreas. Providing a comprehensive overview on the latest advances, this volume of Frontiers in Diabetes will be of particular interest to all healthcare providers involved in the daily management of patients with diabetes or related diseases.
Medical Management of Type 1 Diabetes
Title | Medical Management of Type 1 Diabetes PDF eBook |
Author | Cecilia C. Low Wang |
Publisher | American Diabetes Association |
Pages | 253 |
Release | 2016-11-15 |
Genre | Medical |
ISBN | 1580406777 |
Type 1 diabetes, formerly known as juvenile diabetes, is a complex disorder that requires a great deal of patient-guided self-care. In recent years, advances in diabetes treatment have dramatically shifted potential outcomes in the favor of the patient with diabetes. The challenge for health care professionals is to realize this potential through an individualized, flexible, and responsive treatment plan for patients with type 1 diabetes. Now in its seventh edition, Medical Management of Type 1 Diabetes offers health care providers the newest information and guidelines for the treatment of type 1 diabetes. Built on the foundation of multiple daily insulin injections and insulin pump therapy, this book guides health care providers in helping their patients continually strive for optimal blood glucose control. This new edition focuses on the latest molecular advances, new treatment methods, recent clinical trials, and the American Diabetes Association's Standards of Care. Key topics also include new insulins and administration protocols, advanced carbohydrate counting, and emphasis on continuing patient education. Individual sections address all of the topics in managing type 1 diabetes, including diagnosis and classification/pathogenesis, diabetes standards and education, tools of therapy, special situations, psychosocial factors affecting adherence, quality of life, and well-being and complications. Medical Management of Type 1 Diabetes is an essential addition to any clinician's library for the treatment and understanding of type 1 diabetes.