Performance and control of physiological parameters for diabetes mellitus

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Diabetes mellitus is a common chronic disease that is an ever-increasing public health issue. Canadian data (from Statistics Canada) shows that in 2001, 4.1% of adults (people 12 years of age and older) were diagnosed with diabetes. Most of the long-term health problems associated with diabetes, such as nephropathy, retinopathy, and neuropathy, result from the sustained hyperglycemia (blood glucose > 11.0 mmol/L). To stabilize this condition, exogenous insulin is required for Type I diabetics or Type II diabetics who have failed oral medications. Currently, the most common medical treatment for them recommends three to four daily capillary blood glucose (CBG) measurements, and an equivalent number of subcutaneous insulin injections. In clinical practice, it is difficult to assess whether a certain dosing strategy is optimal or not, and even more even to assess how well a patient is doing in his or her glucose control. Therefore, the objective of this research is to investigate a control algorithm that aims at optimizing the dosing strategy and provide a performance measure for clinicians and patients. The novelty of this project is utilizing advanced modeling and control theory in performance assessment of patient compliance for diabetic control. The uniqueness of this research is in its potential use by many physicians for patient care without fancy equipment. This research will provide a quantification to show to both physicians and patients how good or poor the current practice is. The expected outcome is a performance measure for CBG control on a daily or weekly basis. In patients who are known to be poorly compliant, physicians will be able to recommend what the minimum CBG testing should be and what dosing strategy would be optimal for a particular patient's CBG results. Through these steps and results, the long-term objective of this project will be achieved by improving overall patient compliance and achieving better glycemic control. The impact will be in the reduction of mortality and morbidity related to vascular complications for patients with diabetes.