A probabilistic closed-loop artificial pancreas to handle unannounced meals

描述（由申请人提供）：1型糖尿病是由胰腺产生胰岛素的能力被破坏引起的一种疾病。这导致终生胰岛素需求。这种情况可以通过注射胰岛素或通过皮下的小塑料管连续泵出胰岛素来治疗。目前，胰岛素的剂量需要根据患者的手指血糖水平和食物中的糖含量来计算。人工胰腺的发展可以通过测量血糖水平和计算胰岛素剂量来自动管理这一切，这将极大地改变糖尿病的治疗方法。这项研究的目的是进一步发展我们在一小群患者中开发和研究的人工胰腺系统。我们的初步结果令人鼓舞，我们能够在白天和晚上将血糖水平控制在可接受的水平内。我们的系统将由胰岛素泵、葡萄糖传感器和带有计算器的智能手机组成，计算器通过一个特殊的公式决定需要注射多少胰岛素。通过这项研究，我们希望通过增加一个加速度计来测量病人的活跃程度，从而使系统变得更好。然后，该系统可以根据活动水平改变胰岛素的输送。它还能告诉你什么时候在睡觉，并据此调整胰岛素。我们的系统将被设计成这样，病人不必告诉我们关于饮食或运动的事情。这是一个真正的，自动的，白天和晚上都可以使用的人工胰腺。我们将结合我们已经知道的特殊公式和信息，如吃饭和锻炼的时间，以提高系统的性能。在这项研究中，我们将首先在20名住院的1型糖尿病患者中测试该系统，看看该系统在控制血糖水平方面的效果如何。我们将利用调查结果进一步改进我们的系统。当系统工作正常时，我们将在酒店设置的另一组20名患者中继续测试该系统，为期4天，并进行远程监控。在项目结束时，我们将在一组12名患者中测试该系统，在家中使用该系统进行2周的远程监控。

DESCRIPTION (provided by applicant): Type 1 diabetes is a condition caused by destruction of the pancreas' ability to produce insulin. This results in lifelong insulin requirement. This condition is treated with insulin injections or by a pump that pumps insulin continuously through a small plastic tube that sits under the skin. Currently, insulin doses need to be worked out by the patient depending on their finger-stick blood glucose level and the sugar content in their food. The development of an artificial pancreas that can manage all of this automatically by measuring glucose levels and working out how much insulin to give, would greatly change the treatment of diabetes. The aim of this study is to further develop an artificial pancreas system which we have developed and studied in a small group of patients. Our initial results were encouraging and we were able to control glucose levels within an acceptable level during the day and night. Our system will consist of an insulin pump, glucose sensor and smartphone with a calculator, which determines how much insulin to give by a special formula. Through this study, we hope to make the system better by adding an accelerometer that can measure how active a patient is. The system can then change insulin delivery depending on activity levels. It will also be able to tell when you are sleeping and adjust insulin for this. Our system will be designed so that the patient does not have to tell us about meals or exercise. This is a true, automatic, artificial pancreas for both day and night time. We will incorporate special formulas and information that we know already about, such as timing of meals and exercise, to improve the performance of the system. In this study, we will initially test the system in a group of 20 patients in hospital with type 1 diabetes to see how well the system can work in managing glucose levels. We will use the results to make further improvements to our system. When the system is working well, we will continue testing the system in another group of 20 patients over 4 days in a hotel setting with remote monitoring. Towards the end of this program, we will test the system in a group of 12 patients using the system at home for 2 weeks with remote monitoring.