Effectiveness and safety of a model predictive control (MPC) algorithm for an artificial pancreas system in outpatients with type 1 diabetes (T1D): systematic review and meta-analysis

Diabetology & Metabolic Syndrome

Review

Ji Yean Kwon¹  Yoo Na Hwang¹  Su Lim Kang¹  Sung Min Kim² 

[1] Department of Medical Device and Healthcare, Dongguk University-Seoul, 26, Pil-Dong 3-Ga, 04620, Seoul, Jung-Gu, Republic of Korea;Department of Medical Device and Healthcare, Dongguk University-Seoul, 26, Pil-Dong 3-Ga, 04620, Seoul, Jung-Gu, Republic of Korea;Department of Medical Device Regulatory Science, Dongguk University-Seoul, 26, Pil-dong 3-Ga, 04620, Seoul, Jung-Gu, Republic of Korea;

关键词: Artificial pancreas;    Algorithm;    Model predictive control;    Hypoglycemia;    Type 1 diabetes;   

DOI  :  10.1186/s13098-022-00962-2

 received in 2022-08-30, accepted in 2022-12-02,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study was to assess the effectiveness and safety of a model predictive control (MPC) algorithm for an artificial pancreas system in outpatients with type 1 diabetes.MethodsWe searched PubMed, EMBASE, Cochrane Central, and the Web of Science to December 2021. The eligibility criteria for study selection were randomized controlled trials comparing artificial pancreas systems (MPC, PID, and fuzzy algorithms) with conventional insulin therapy in type 1 diabetes patients. The heterogeneity of the overall results was identified by subgroup analysis of two factors including the intervention duration (overnight and 24 h) and the follow-up periods (< 1 week, 1 week to 1 month, and > 1 month).ResultsThe meta-analysis included a total of 41 studies. Considering the effect on the percentage of time maintained in the target range between the MPC-based artificial pancreas and conventional insulin therapy, the results showed a statistically significantly higher percentage of time maintained in the target range in overnight use (10.03%, 95% CI [7.50, 12.56] p < 0.00001). When the follow-up period was considered, in overnight use, the MPC-based algorithm showed a statistically significantly lower percentage of time maintained in the hypoglycemic range (−1.34%, 95% CI [−1.87, −0.81] p < 0.00001) over a long period of use (> 1 month).ConclusionsOvernight use of the MPC-based artificial pancreas system statistically significantly improved glucose control while increasing time maintained in the target range for outpatients with type 1 diabetes. Results of subgroup analysis revealed that MPC algorithm-based artificial pancreas system was safe while reducing the time maintained in the hypoglycemic range after an overnight intervention with a long follow-up period (more than 1 month).

【 授权许可】

CC BY   
© The Author(s) 2022

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