a Run-to-Run Algorithm for Glucose Regulation

描述(由申请人提供)： 这项工作的长期目标是开发新的算法方法，以自动方式优化胰岛素向1型糖尿病患者的输送。具体地说，我们的目标是开发一种策略，灵感来自于化学加工行业建立的Run-to-Run控制理论，该策略从之前对胰岛素剂量的反应序列(在几天的过程中)“学习”，并最佳地预测即将到来的一天的适当策略。工程学中的“周期”概念将被扩展到管理24小时重复的饮食、活动和睡眠周期以及相应剂量的胰岛素。该算法将在模拟和临床试验中测试对传感器噪声、患者特征的不确定性、餐后血糖峰值时间的可变性以及膳食中碳水化合物含量的可变性的稳健性。该项目的具体目标是：i)构建用于根据血糖水平升高(或降低)计算最佳胰岛素剂量的预测性患者敏感性模型；ii)开发连续运行的胰岛素推注算法，以根据先前的血糖水平和胰岛素剂量的历史提供随后几天的校正；以及iii)通过改变碳水化合物含量的膳食挑战来评估该算法的稳健性。AIMS将从系统工程中提取原型算法，并在一系列临床测试中进行验证。系统工程师和著名的糖尿病研究人员在既定的临床研究环境中拟议的合作将允许真正被描述为“创新”的方法的新融合。提案中的医疗合作者位于著名的桑苏姆医学研究所，该研究所距离加州大学圣巴巴拉分校校园不到10英里。将促进人员交流，使参与该项目的学生和博士后在整个项目期间都能在学院和大学工作。

DESCRIPTION (provided by applicant): The long term objective of this work is to develop new algorithmic approaches to optimize the delivery of insulin in an automated fashion to people with type 1 diabetes. Specifically, we aim to develop a strategy, inspired by run-to-run control theory established by the chemical process industries, that "learns" from the previous sequence of glucose responses to insulin dosing (over the course of days), and optimally predicts the appropriate strategy for the forthcoming day. The notion of a "cycle" in engineering will be extended to manage the 24 hour routine of repeated meals, activities, and sleep cycles and the corresponding dosing of insulin. The algorithm will be tested in both simulation and clinical trials for robustness to sensor noise, uncertainty in the patient characterization, variability in the timing of the postprandial glucose peak, and variability in the carbohydrate content in the meals. The Specific Aims of this project are to: i) construct predictive patient sensitivity models for calculation of optimal insulin dosing from elevated (or depressed) glucose levels, ii) develop run-to-run algorithm for insulin bolus dosing to provide corrections in subsequent days based on previous history of glucose levels and insulin dosage, and iii) evaluate the robustness of the algorithm through meal challenges of varying carbohydrate content. The aims will blend prototype algorithms that are drawn from systems engineering with validation in a series of clinical tests. The proposed collaboration between systems engineers and renowned diabetes researchers in an established clinical research setting will allow a novel fusion of methods that can be truly characterized as "innovative". The medical collaborators in the proposal are located at the prestigious Sansum Medical Research Institute, which is located less than 10 miles from the campus of the University of California, Santa Barbara. The exchange of personnel will be facilitated, allowing the student and post-doc supported on this project to work at both the institute and the university over the span of the project.