Related Experiment Video
Updated: May 17, 2026

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test (OGTT) and Insulin Tolerance Test (ITT)
Published on: January 7, 2018
Effect of insulin feedback on closed-loop glucose control: a crossover study.
Jessica L Ruiz1, Jennifer L Sherr, Eda Cengiz
1Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA.
The insulin feedback (IFB) modification to proportional-integral-derivative (PID) controllers significantly reduced hypoglycemia in closed-loop systems. This enhanced control prevents low blood glucose events without worsening post-meal glucose levels.
Area of Science:
- Diabetes technology
- Artificial pancreas development
- Glycemic control strategies
Background:
- Closed-loop (CL) insulin delivery systems using proportional-integral-derivative (PID) controllers are prone to delayed postprandial hypoglycemia.
- An insulin feedback (IFB) modification was developed to mitigate hypoglycemia risk in PID-based CL systems.
- This study investigates the impact of IFB on CL blood glucose (BG) control.
Purpose of the Study:
- To evaluate the effect of an insulin feedback (IFB) modification on closed-loop (CL) blood glucose (BG) control.
- To compare BG excursions and hypoglycemia rates between standard PID and PID + IFB control algorithms.
- To assess the safety and efficacy of IFB in preventing postprandial hypoglycemia.
Main Methods:
- Four subjects used the Medtronic ePID CL system for 24-hour periods under both PID and PID + IFB control.
- Identical meals were provided at 8:00 AM, 1:00 PM, and 6:00 PM; no premeal manual boluses were administered.
- Key metrics included reference BG excursions and postprandial BG area under the curve (AUC) from 0-5 hours.
Main Results:
- The PID + IFB system resulted in higher mean BG levels (153 ± 54 mg/dl) compared to PID alone (133 ± 56 mg/dl).
- Postmeal BG excursions and AUCs were similar between PID and PID + IFB conditions.
- Crucially, eight hypoglycemic events (< 60 mg/dl) occurred with PID control, versus none with PID + IFB.
Conclusions:
- The addition of IFB to the PID controller significantly reduced hypoglycemia incidence without compromising meal glucose control.
- Higher mean BG levels with PID + IFB may relate to system gain determination in this study.
- The prevention of postprandial hypoglycemia suggests PID + IFB may enable lower target glucose levels and improved overall glycemic management.
More Related Videos
08:32Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain
Published on: January 4, 2018
06:13Randomized Controlled Trial to Study the Acute Effects of Strength Exercise on Insulin Sensitivity in Obese Adults
Published on: December 1, 2023
Related Concept Videos
Feedback Loops
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion
Insulin and C-peptide are co-secreted in...
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Crossover Experiments
Crossover designs are performed even with smaller sample sizes since the samples can act as their controls. These are better than simple randomized trials since patients are exposed to all the treatments.
Glucose Homeostasis: Regulation of Blood Glucose
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Hypoglycemia and Glucagon