A critical assessment of algorithms and challenges in the development of a closed-loop artificial pancreas.
A critical assessment of algorithms and challenges in the development of a closed-loop artificial pancreas.
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DOI：
10.1089/dia.2005.7.28
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发表时间：
2005-02-01
影响因子：
5.4
通讯作者：
Bequette, B Wayne
中科院分区：
文献类型：
--
作者：
Bequette, B Wayne
人工胰腺的发展被放在反馈控制系统领域的历史背景下，从古希腊的水钟开始，并包括对当前控制复杂系统的努力的讨论。第一代人工胰腺装置包括两个操纵变量(胰岛素和葡萄糖输注)和误差的非线性函数(所需葡萄糖浓度与测量葡萄糖浓度之差)，以最大限度地减少高血糖，同时避免低血糖。对于这些基于静脉的系统，胰岛素输注和血糖测量之间的动态滞后相对较小。连续血糖感应、快速作用的胰岛素类似物和成熟的胰岛素泵市场的进步使我们接近实现闭环式人工胰腺的商业实现。模型预测控制是一种适合于闭环人工胰腺的控制方法，本文对其进行了深入的讨论。一个仍然存在的主要挑战是处理未知的血糖紊乱(餐)，并提出了一种方法，以预测餐对未来血糖值的影响为基础进行当前的胰岛素输注作用。需要更好的“膳食模型”，因为对膳食对未来血糖值影响的有限了解限制了任何控制算法的性能。
The development of an artificial pancreas is placed in the context of the history of the field of feedback control systems, beginning with the water clock of ancient Greece, and including a discussion of current efforts in the control of complex systems. The first generation of artificial pancreas devices included two manipulated variables (insulin and glucose infusion) and nonlinear functions of the error (difference between desired and measured glucose concentration) to minimize hyperglycemia while avoiding hypoglycemia. Dynamic lags between insulin infusion and glucose measurement were relatively small for these intravenous-based systems. Advances in continuous glucose sensing, fast-acting insulin analogs, and a mature insulin pump market bring us close to commercial realization of a closed-loop artificial pancreas. Model predictive control is discussed in-depth as an approach that is well suited for a closed-loop artificial pancreas. A major challenge that remains is handling an unknown glucose disturbance (meal), and an approach is proposed to base a current insulin infusion action on the predicted effect of a meal on future glucose values. Better "meal models" are needed, as a limited knowledge of the effect of a meal on the future glucose values limits the performance of any control algorithm.