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

健康人的血糖水平受两种激素的严格控制：胰岛素和胰高血糖素。胰岛素是降低血糖的重要激素，在1型糖尿病中失去了分泌。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，但血糖控制仍然是一个问题，对大多数患者来说是一个很大的挑战。我们的研究小组正在稳步发展一种外部人工胰腺，可以自动调节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高血糖素）和智能给药算法（根据传感器的读数控制胰岛素和胰高血糖素的输送）。我们已经在我们的临床研究机构的几个临床试验中测试了人工胰腺，结果很有希望。与传统泵治疗相比，人工胰腺显著改善了血糖控制，降低了低血糖的风险。目前，我们正在进行更长时间、更大规模的家庭现实研究。该项目的目的是改进人工胰腺，使其能够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，面对患者胰岛素需求在数周/数月内的缓慢变化，这种新算法将保持并提高系统的性能。我们的目标是在计算机模拟环境中测试这个新系统，然后在50名青少年中临床测试3周。人工智能在改善生活质量、改善健康状况、预防低血糖事件、为体育活动提供信心以及减轻糖尿病患者、家庭和医疗保健提供者的主要负担方面具有巨大的潜力。

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.