葡萄糖变化率和机上胰岛素联合加权区域模型预测控制
Sunil Deshpande1, Francis J Doyle1, Eyal Dassau1
1Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
概括
本研究引入了一个自适应区模型预测控制 (MPC) 用于闭环胰岛素输送. 这种新系统有效地控制血糖水平,降低高血糖,而不会增加低血糖风险.
科学领域:
- 生物医学工程 生物医学工程
- 控制系统工程 控制系统工程
- 内分泌学 在内分泌学.
背景情况:
- 闭环胰岛素输送系统旨在自动化糖尿病的血糖管理.
- 现有系统面临的挑战是可变的胰岛素敏感性,不足的输送和食组成,导致长期高血糖症.
- 模型预测控制 (MPC) 为先进的血糖控制提供了一个有希望的框架.
研究的目的:
- 设计和评估一个适应区模型预测控制 (MPC) 的闭环胰岛素输送.
- 通过将自适应权重方案纳入MPC成本函数来解决长期高血糖症.
- 通过考虑葡萄糖变化速率 (ROC) 和机上胰岛素 (IOB) 来改善葡萄糖控制,以进行个性化调整.
主要方法:
- 开发了一个区域MPC,在成本函数中采用适应权重方案.
- 权重方案共同考虑预测的葡萄糖ROC和IOB来调节血糖控制.
- 在门诊研究中使用模拟场景 (诱导耐药性,名义) 和临床验证来评估控制器.
主要成果:
- 适应区MPC在整个葡萄糖范围中表现出一致的改善,而不会增加低血糖风险.
- 在没有进食前玻尿酸的诱导阻力场景中,在70-180 mg/dL范围内的时间得到改善 (53.5%与48.9%,p<0.001).
- 在更紧密的70-140毫克/分升范围内的夜间时间显著改善 (70.9%与52.9%,p<0.001).
结论:
- 拟议的适应区MPC在闭环胰岛素输送中有效管理长期高血糖症.
- 适应性权衡方案通过响应葡萄糖ROC和IOB动态来增强葡萄糖控制.
- 临床验证支持这种先进的血糖控制策略的实用性和安全性.
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