Closed-loop Artificial Pancreas: Algorithm Engineering and Clinical Evaluation

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DESCRIPTION (provided by applicant): This proposal seeks to build on a promising line of research that has already resulted in a working prototype of a closed-loop artificial pancreas (AP) that combines continuous glucose sensing with automated insulin delivery via a control algorithm. The AP consists of three components: a continuous glucose sensor, a continuous subcutaneous insulin infusion pump, and artificial pancreas software (APS). The APS is in the final stages of review by the Food and Drug Administration for use in fully automated closed-loop control clinical trials (Master File MAF-1625 ). The specific aims are: 1) Development of the Artificial Pancreas to optimize insulin delivery and minimize meal-related excursions in glucose, 2) Expansion of the Artificial Pancreas to include alterations and individual differences in insulin sensitivity, and 3) Further development of the algorithms using multi-parametric model predictive control (mpMPC) in order to reduce online computation, develop effective online monitoring strategies to ensure that the AP is operating properly, and accommodate multiple input systems. In the quest to achieve our overall goal of a completely automated closed-loop device for insulin delivery, we will utilize a staged approach in which the clinical studies also have a concurrent engineering design approach in order to refine our AP. In silico testing and human in-clinic testing will be used to validate each step of model development. The ultimate goal of this line of research is a functional AP that will provide around-the-clock glucose regulation through controlled insulin delivery in response to detected patterns of changes in glucose levels in order to achieve optimal glucose regulation in subjects with type 1 diabetes. Special consideration will be given to the amount of potentially available insulin from prior infusions (insulin-on-board) in setting constraints for subsequent insulin delivery. The proposal describes multi-parametric model predictive control approaches to glycemic regulation and extensive in silico and clinical validation of the AP under overnight, meal, and exercise conditions. This application grows out of a long-standing collaboration between systems engineers at the University of California, Santa Barbara (UCSB) and research physicians specializing in diabetes research at the prestigious Sansum Diabetes Research Institute (Sansum) located less than ten miles away. This team has distinguished itself as a major contributor to the artificial pancreas literature and as an international leader in diabetes technology. PUBLIC HEALTH RELEVANCE: This project aims to develop a functional artificial pancreas that will provide around-the-clock glucose regulation through controlled insulin delivery in response to detected patterns of changes in glucose levels in order to achieve optimal glucose regulation in subjects with type 1 diabetes. Special consideration will be given to the amount of potentially available insulin from prior infusions (insulin-on-board) in setting constraints for subsequent insulin delivery. The proposal describes multi-parametric model predictive control approaches to glycemic regulation and extensive in silico and clinical validation of the AP under overnight, meal, and exercise conditions.