Incorrect AM/PM Insulin Pump Clock Settings Can Result in an Unstable Insulin Dosing Feedback Loop

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

Homeostasis is the maintenance of a stable internal environment within the body, which is crucial for the proper functioning of cells, tissues, organs, and organ systems. The body has various control mechanisms that work together to regulate various physiological parameters such as temperature, blood pressure, pH balance, and fluid balance, to name a few. These control mechanisms are based on feedback loops that can be either positive or negative.
However, sometimes these feedback loops fail,...

In most cases, excessive hormone production is prevented by negative feedback—a loop that starts with a stimulus inducing the release of a particular substance, like a hormone, to maintain a certain level before triggering a signal that results in a decrease in further release of the hormone.

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...

Proportional-Integral (PI) controllers are essential in many control systems to improve stability and performance. They are commonly used in everyday devices like thermostats to enhance system damping and reduce steady-state error. When the zero in the controller's transfer function is optimally placed, the system benefits significantly in terms of stability and accuracy.
Acting as a low-pass filter, the PI controller slows the system's response and extends settling times. This requires...

Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...