A Review of Closed-Loop Algorithms for Glycemic Control in the Treatment of Type 1 Diabetes

Algorithms

Joseph El Youssef¹  Jessica Castle¹ 

[1] id="af1-algorithms-02-00518">Schnitzer Diabetes Center, mailstop OP05-DC, Oregon Health and Science University. 3181 SW Sam Jackson Park Road,  Portland ORUSA  972

关键词: diabetes;    sensor;    algorithm;    closed loop;   

DOI  :  10.3390/a2010518

来源: mdpi

【 摘 要 】

With the discovery of insulin came a deeper understanding of therapeutic options for one of the most devastating chronic diseases of the modern era, diabetes mellitus. The use of insulin in the treatment of diabetes, especially in those with severe insulin deficiency (type 1 diabetes), with multiple injections or continuous subcutaneous infusion, has been largely successful, but the risk for short term and long term complications remains substantial. Insulin treatment decisions are based on the patient’s knowledge of meal size, exercise plans and the intermittent knowledge of blood glucose values. As such, these are open loop methods that require human input. The idea of closed loop control of diabetes treatment is quite different: automated control of a device that delivers insulin (and possibly glucagon or other medications) and is based on continuous or very frequent glucose measurements. Closed loop insulin control for type 1 diabetes is not new but is far from optimized. The goal of such a system is to avoid short-term complications (hypoglycemia) and long-term complications (diseases of the eyes, kidneys, nerves and cardiovascular system) by mimicking the normal insulin secretion pattern of the pancreatic beta cell.

A control system for automated diabetes treatment consists of three major components, (1) a glucose sensing device that serves as the afferent limb of the system; (2) an automated control unit that uses algorithms which acquires sensor input and generates treatment outputs; and (3) a drug delivery device (primarily for delivery of insulin), which serves as the system’s efferent limb.

There are several major issues that highlight the difficulty of interacting with the complex unknowns of the biological world.

【 授权许可】

CC BY   
© 2009 by the authors; licensee Molecular Diversity Preservation International, Basel, Switzerland.