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Adaptive Biobehavioral Control: A Pilot Analysis of Human-Machine Coadaptation in Type 1 Diabetes.

Patricio Colmegna1,2, Ryan McFadden1,2, Chiara Fabris1

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Summary

This study introduced the adaptive biobehavioral control (ABC) method to improve automated insulin delivery (AID) systems by integrating user adaptation. The Web Information Tool (WIT) safely enhanced AID, showing improved time in target glucose range for users with type 1 diabetes.

Keywords:
automated insulin deliverybiobehavioral controlcloud-based systemsself-treatment behaviorstherapy parameter adaptation

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Area of Science:

  • Biomedical Engineering
  • Endocrinology
  • Diabetes Technology

Background:

  • Automated insulin delivery (AID) systems require user adaptation alongside physiological adaptation.
  • The adaptive biobehavioral control (ABC) method addresses this by integrating AID into a cloud-based ecosystem.
  • The Web Information Tool (WIT) facilitates ABC through physiological and behavioral adaptation modules.

Purpose of the Study:

  • To assess the safety and efficacy of the WIT system, which enhances AID with adaptive biobehavioral control.
  • To evaluate the impact of a Behavioral Adaptation Module (BAM) within the WIT ecosystem on glycemic control in type 1 diabetes.
  • To determine if integrating AID into an information cloud-based ecosystem improves user outcomes.

Main Methods:

  • An 8-week randomized, two-arm parallel pilot study involving 30 participants with type 1 diabetes (T1D).
  • All participants used an AID system enhanced with a Physiological Adaptation Module (PAM).
  • The experimental group additionally used a Behavioral Adaptation Module (BAM) within the WIT ecosystem.

Main Results:

  • No severe hypoglycemia, diabetic ketoacidosis (DKA), or other serious adverse events were reported, indicating WIT safety.
  • The experimental group showed a significantly higher time in the 70-140 mg/dL glucose range (P=0.035).
  • No significant difference was observed in overall time in range (70-180 mg/dL) (P=0.161), with no increased time below range.

Conclusions:

  • Integrating an AID system into the WIT ecosystem is safe for individuals with T1D.
  • The WIT system, incorporating adaptive biobehavioral control, shows potential for improving glycemic management.
  • Further validation in a full-scale study is warranted to confirm these findings.