Artificial Pancreas: Evaluating the ARG Algorithm Without Meal Announcement
Artificial Pancreas: Evaluating the ARG Algorithm Without Meal Announcement
复制标题
人工胰腺：在没有用餐通知的情况下评估 ARG 算法
DOI：
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发表时间：
2019
影响因子：
5
通讯作者：
R. Sánchez
中科院分区：
文献类型：
--
作者：
E. Fushimi;P. Colmegna;H. De Battista;F. Garelli;R. Sánchez
背景：无论是在标准的基础给药治疗下，还是在混合闭环对照下，1型糖尿病患者都被要求计算碳水化合物(CHO)。然而，Cho计数不仅繁重，而且容易出错。最近，一种不需要餐前胰岛素推注的人工胰腺算法--所谓的血糖自动调节(ARG)--被引入。在它的第一项试验性临床研究中，尽管不需要准确的CHO计数，但受试者仍然需要宣布进餐时间并对进餐规模进行分类。方法：提出了一种自动开关信号发生器(SSG)，从控制策略中去掉了手动用餐时间通知。SSG基于卡尔曼滤波，仅适用于连续的血糖监测读数。结果：在不同类型的混合餐点和患者内部变异性的影响下，对ARG算法进行了电子测试，并与ARG算法进行了对比。模拟显示，对于缓慢吸收的膳食，采用未经宣布的策略(Argam：78.1[68.6-80.2]%(中位数[IQR])和ARGum：87.8[84.5-90.6]%)，处于正常血糖范围[70-180]mg/dL的时间增加，而对于快速吸收的膳食(Argam：87.4[86.0-88.9]%和ARGum：87.6[86.1-88.8]%)也有类似的结果。另一方面，当考虑患者内部的变异性时，正常血糖的时间也是相似的(Argam：81.4[75.4-83.5]%，Argum：80.9[77.0-85.1]%)。结论：在电子计算机上的结果表明，在未宣布膳食的情况下进行ARG算法的体内评估是可行的。
Background: Either under standard basal-bolus treatment or hybrid closed-loop control, subjects with type 1 diabetes are required to count carbohydrates (CHOs). However, CHO counting is not only burdensome but also prone to errors. Recently, an artificial pancreas algorithm that does not require premeal insulin boluses—the so-called automatic regulation of glucose (ARG)—was introduced. In its first pilot clinical study, although the exact CHO counting was not required, subjects still needed to announce the meal time and classify the meal size. Method: An automatic switching signal generator (SSG) is proposed in this work to remove the manual mealtime announcement from the control strategy. The SSG is based on a Kalman filter and works with continuous glucose monitoring readings only. Results: The ARG algorithm with unannounced meals (ARGum) was tested in silico under the effect of different types of mixed meals and intrapatient variability, and contrasted with the ARG algorithm with announced meals (ARGam). Simulations reveal that, for slow-absorbing meals, the time in the euglycemic range, [70-180] mg/dL, increases using the unannounced strategy (ARGam: 78.1 [68.6-80.2]% (median [IQR]) and ARGum: 87.8 [84.5-90.6]%), while similar results were found with fast-absorbing meals (ARGam: 87.4 [86.0-88.9]% and ARGum: 87.6 [86.1-88.8]%). On the other hand, when intrapatient variability is considered, time in euglycemia is also comparable (ARGam: 81.4 [75.4-83.5]% and ARGum: 80.9 [77.0-85.1]%). Conclusion: In silico results indicate that it is feasible to perform an in vivo evaluation of the ARG algorithm with unannounced meals.
影响因子：
5.4
作者：
Cameron, Faye M.;Ly, Trang T.;Bequette, B. Wayne
通讯作者：
Bequette, B. Wayne