Developing and clinically testing a learning algorithm that optimizes the performance of the artificial pancreas

在健康人中，血糖水平受到两种荷尔蒙的严格控制：胰岛素和胰升糖素。胰岛素是一种降低血糖的重要荷尔蒙，它的分泌在1型糖尿病患者中会丢失。因此，1型糖尿病患者目前通过注射或胰岛素泵进行强化胰岛素治疗，但血糖控制仍然存在问题，对大多数患者来说是一个巨大的挑战。我们团队正在稳步发展研究，以开发一种外部人工胰腺，自动调节1型糖尿病患者的血糖水平。人工胰腺由三部分组成：连续血糖传感器(用于测量血糖水平)、输液泵(用于注入胰岛素和胰升糖素)和智能剂量算法(根据传感器的读数控制胰岛素和胰升糖素的输送)。我们在我们的临床研究机构对人工胰腺进行了几次临床试验，结果令人满意。与传统的泵疗法相比，人工胰腺显著改善了血糖控制，降低了低血糖风险。我们目前正在家中进行更长时间和更大规模的真实研究。这个项目的目的是改进人工胰腺，以便它随着时间的推移了解患者的胰岛素需求，并随着患者胰岛素需求的变化而适应。我们相信，这种新的算法将保持和改进系统的性能，以应对患者在几周/几个月内胰岛素需求的缓慢变化。我们的目标是在计算机模拟环境中测试这一新系统，然后在50名青少年中临床应用3周。这种人工系统具有巨大的潜力，可以提高生活质量，改善健康状况，防止低血糖事件，为身体活动提供信心，并减轻患者、家庭和医疗保健提供者的糖尿病负担。

In healthy individuals, blood sugar levels are tightly controlled by two hormones: insulin and glucagon. Secretion of insulin, avital hormone to reduce blood sugar, is lost in type 1 diabetes. Thus, type 1 diabetes patients are currently treated byintensive insulin therapy through injections or insulin pump, but glucose control remains problematic and a big challenge formost patients.Research is under steady progress by our group to develop an external artificial pancreas that automatically regulatesglucose levels in patients with type 1 diabetes. The artificial pancreas is composed of three components: a continuousglucose sensor (to measure glucose levels), infusion pumps (to infuse insulin and glucagon), and an intelligent dosingalgorithm (to control insulin and glucagon delivery based on the readings of the sensor).We have tested the artificial pancreas in several clinical trials in our clinical research facility and the results were promising.The artificial pancreas improved significantly glucose control and reduced the risk of hypoglycemia compared toconventional pump therapy. We are currently moving to longer and larger real-life studies at home.The aim of this project is to improve the artificial pancreas so that it learns the insulin needs of the patients over time andadapts as the patients insulin needs changes. We believe that this new algorithm will maintain and improve the performanceof the system in face of slow changes in patients insulin needs over weeks/months. We aim to test this new system in acomputer simulation environment then clinically in 50 adolescents for 3 weeks.The artificial has enormous potential to improve quality of life, improve health outcomes, prevent hypoglycemic events,provide confidence for physical activities and alleviate key aspect of the burden of diabetes for patients, families and healthcare providers.