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An evaluation of "I, Pancreas" algorithm performance in silico.

Malgorzata E Wilinska1, Marianna Nodale

  • 1University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom. mew37@medschl.cam.ac.uk

Journal of Diabetes Science and Technology
|February 11, 2010
PubMed
Summary

The "I, Pancreas" algorithm safely controlled glucose in critically ill virtual patients, achieving tight glycemic control 38% of the time during a 48-hour simulation.

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Area of Science:

  • Critical Care Medicine
  • Diabetes Technology
  • Computational Biology

Background:

  • Achieving tight glycemic control in critically ill patients is challenging.
  • New insulin titrating algorithms are needed to improve glucose management.
  • The
  • algorithm is a novel approach for insulin titration.

Purpose of the Study:

  • To evaluate the performance of the proposed "I, Pancreas" insulin titrating algorithm.
  • To assess the algorithm's ability to achieve tight glycemic control in a simulated critically ill population.
  • To determine the safety and efficacy of the algorithm in silico.

Main Methods:

  • A simulation environment with 10 critically ill virtual subjects was utilized.
  • The "I, Pancreas" algorithm was implemented in MATLAB.

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  • Glucose control was simulated over a 48-hour period.
  • Main Results:

    • Mean blood glucose was maintained at 6.5 +/- 0.4 mmol/liter.
    • The algorithm achieved tight glycemic control 38% of the time (32-44%).
    • A single episode of mild hypoglycemia was observed over 480 hours of simulated control.

    Conclusions:

    • The "I, Pancreas" algorithm demonstrated safe glucose control in a simulated critical care setting.
    • The algorithm showed potential for achieving tight glycemic control in critically ill patients.
    • Further in vivo studies are warranted to validate these in silico findings.