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Manual Closed-Loop Insulin Delivery Using a Saddle Point Model Predictive Control Algorithm: Results of a Crossover

Isabelle Guilhem1,2, Maxime Penet3, Anaïs Paillard1,2

  • 11 CHU de Rennes, Department of Endocrinology, Diabetes and Nutrition, Rennes, France.

Journal of Diabetes Science and Technology
|July 6, 2017
PubMed
Summary

The Saddle Point Model Predictive Control (SP-MPC) algorithm reduced hypoglycemia by 2.8-fold overnight in type 1 diabetes patients compared to sensor-augmented pump therapy. This pilot study suggests improved glucose control with SP-MPC.

Keywords:
artificial pancreasclosed loopmodel predictive controlsensor-augmented pump therapytype 1 diabetes

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Diabetes Technology

Background:

  • Type 1 diabetes management requires precise glucose control.
  • Nocturnal hypoglycemia is a significant risk with current diabetes therapies.
  • Advanced algorithms are being developed to improve automated insulin delivery.

Purpose of the Study:

  • To evaluate the efficacy of a novel closed-loop algorithm, Saddle Point Model Predictive Control (SP-MPC).
  • To assess SP-MPC's ability to achieve normoglycemia overnight.
  • To determine if SP-MPC reduces hypoglycemia risk in type 1 diabetes patients.

Main Methods:

  • A randomized crossover study involving 10 adult type 1 diabetes patients.
  • Overnight treatment comparison: SP-MPC closed-loop versus sensor-augmented pump (SAP) therapy.
  • Primary endpoints: time in target glucose range (70-145 mg/dl) and time below 70 mg/dl.

Main Results:

  • No significant difference in time spent within the target glucose range.
  • A 2.8-fold reduction in hypoglycemic events (<70 mg/dl) with SP-MPC compared to SAP (P=.02).
  • Significantly lower glucose levels above 145 mg/dl and Hyperglycemic Bio-Glucose Index (HBGI) with SP-MPC (P=.03 and P=.02, respectively).

Conclusions:

  • The SP-MPC algorithm shows promise for improving overnight glucose management in type 1 diabetes.
  • SP-MPC may offer a reduced risk of hypoglycemia compared to standard sensor-augmented pump therapy.
  • This pilot study supports further investigation of SP-MPC for automated insulin delivery.