Feedback control dynamics for glucose controlled insulin infusion system

Miles Laboratories has developed a Glucose Controlled Insulin Infusion System (GCIIS) designated by the Trademark (BIOSTATOR) as a tool to investigate the physiologic control parameters of carbohydrate metabolism and regulatory deficiencies in diabetes. It consists, in principle, of a rapid on-line glucose analyzer, a computer/controller for the calculation and control of insulin or dextrose infusion, and a multichannel infusion system. A silent printer records, on a minute-by-minute basis, the glucose value measured, the insulin and/or dextrose infusion rates, and the cumulative total of the insulin infused. The on-line glucose analyzer employs an electrochemical sensor with immobilized glucose oxidase and measures the hydrogen peroxide produced. Its linearity extends beyond 700 mg/dl glucose; it permits a rapid two-point calibration of the sensor and the overall calibration of the on-line analyzer without disconnecting the catheter from the patient. The system's response time, including blood sample transport from the patient, is less than 90 seconds with a blood loss of approximately 50 ml per 24 h. The insulin and dextrose infusions are governed by control algorithms; various mathematical models have been developed and employed toward improved feedback control dynamics. The rapid glucose analyzer eliminates the need for the calculation of a "predicted" glucose value and permits, instead, the use of a derivative function for dynamic control. A multichannel infusion system combines the principles of a peristaltic pump with the advantages of a precision pump performance and individual computer control for each of the pump channels.