0000000000404091
AUTHOR
Jorge Bondia
Extensive Assessment of Blood Glucose Monitoring During Postprandial Period and Its Impact on Closed-Loop Performance.
[EN] Background: Closed-loop (CL) systems aims to outperform usual treatments in blood glucose control and continuous glucose monitors (CGM) are a key component in such systems. Meals represents one of the main disturbances in blood glucose control, and postprandial period (PP) is a challenging situation for both CL system and CGM accuracy. Methods: We performed an extensive analysis of sensor¿s performance by numerical accuracy and precision during PP, as well as its influence in blood glucose control under CL therapy. Results: During PP the mean absolute relative difference (MARD) for both sensors presented lower accuracy in the hypoglycemic range (19.4 ± 12.8%) than in other ranges (12.2…
Controller Design Under Fuzzy Pole-Placement Specifications: An Interval Arithmetic Approach
This paper discusses fuzzy specifications for robust controller design, as a way to define different specification levels for different plants in a family and allow the control of performance degradation. Controller synthesis will be understood as mapping a fuzzy plant onto a desired fuzzy set of closed-loop specifications. In this context, a fuzzy plant is considered as a possibility distribution on a given plant space. In particular, pole placement in linear plants with fuzzy parametric uncertainty is discussed, although the basic idea is general and could be applied to other settings. In the case under consideration, the controller coefficients are the solution of a fuzzy linear system o…
A Multiple Local Models Approach to Accuracy Improvement in Continuous Glucose Monitoring
Continuous glucose monitoring (CGM) devices estimate plasma glucose (PG) from measurements in compartments alternative to blood. The accuracy of currently available CGM is yet unsatisfactory and may depend on the implemented calibration algorithms, which do not compensate adequately for the differences of glucose dynamics between the compartments. Here we propose and validate an innovative calibration algorithm for the improvement of CGM performance.CGM data from GlucoDay(®) (A. Menarini, Florence, Italy) and paired reference PG have been obtained from eight subjects without diabetes during eu-, hypo-, and hyperglycemic hyperinsulinemic clamps. A calibration algorithm based on a dynamic glo…
Plasma Insulin Levels and Hypoglycemia Affect Subcutaneous Interstitial Glucose Concentration
[EN] Background: Continuous glucose monitoring (CGM) accuracy during hypoglycemia is suboptimal. This might be partly explained by insulin or hypoglycemia-induced changes in the plasma interstitial subcutaneous (SC) fluid glucose gradient. The aim of the present study was to assess the role of plasma insulin (PI) and hypoglycemia itself in the plasma and interstitial SC fluid glucose concentration in patients with type 1 diabetes mellitus. Methods: Eleven subjects with type 1 diabetes (age 36.59.1 years, HbA(1c) 7.90.4% [62.8 +/- 2.02mmol/mol]; mean +/- standard deviation) were evaluated under hyperinsulinemic euglycemia and hypoglycemia. Each subject underwent two randomized crossover clam…
Guaranteed tuning of PID controllers for parametric uncertain systems
This paper presents a methodology for tuning the controller of a parametric uncertain plant in order to guarantee the satisfaction of specifications. These specifications are defined by means of an interval reference model that represents the set of satisfactory time or frequency behaviors. The controller synthesis is then formulated as a set-inclusion problem in the frequency domain. Interval techniques for the solution of constraint satisfaction problems are applied to design fixed-structure controllers in a guaranteed manner. In particular, PID controllers are considered since they are widely used in industry.
Comprehensive pharmacokinetic model of insulin Glargine and other insulin formulations.
In this paper, a comprehensive pharmacokinetic model for different insulin formulations including insulin Glargine is developed based on the model proposed by Trajanoski et al. (1993). Current models show limitations for insulin Glargine due to the appearance of an uncharacteristic peak in the concentration-time evolution of plasma insulin that does not coincide with real experimental data. This important limitation has been solved in this paper by introducing a new virtual insulin state called the bound state, in addition to the dimeric and hexameric ones. Trying to describe the retarded action of insulin Glargine, the modeling idea behind this approach is that immediately after the subcut…
Real-time estimation of plasma insulin concentration from continuous glucose monitor measurements
Continuous glucose monitors can measure interstitial glucose concentration in real time for closed-loop glucose control systems, known as artificial pancreas. These control systems use an insulin feedback to maintain plasma glucose concentration within a narrow and safe range, and thus to avoid health complications. As it is not possible to measure plasma insulin concentration in real time, insulin models have been used in literature to estimate them. Nevertheless, the significant interand intra-patient variability of insulin absorption jeopardizes the accuracy of these estimations. In order to reduce these limitations, our objective is to perform a real-time estimation of plasma insulin co…