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，以自动化的方式优化1型糖尿病患者的胰岛素输送。具体来说，我们的目标是开发一种策略，灵感来自化学过程工业建立的运行控制理论，从先前的葡萄糖对胰岛素给药的反应序列（在几天的过程中）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”概念将扩展到管理24小时重复进餐、活动和睡眠周期以及相应的胰岛素剂量。将在模拟和临床试验中测试该算法对传感器噪声的鲁棒性、患者表征的不确定性、餐后葡萄糖峰值时间的变异性以及膳食中碳水化合物含量的变异性。本项目的具体目的是：i）构建预测性患者敏感性模型，用于根据升高（或降低）的葡萄糖水平计算最佳胰岛素剂量，ii）开发胰岛素餐时给药的运行到运行算法，以根据先前的葡萄糖水平和胰岛素剂量历史在随后几天提供校正，iii）通过不同碳水化合物含量的膳食挑战评价算法的稳健性。这些目标将把从系统工程中得出的原型算法与一系列临床测试中的验证相结合。系统工程师和著名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一种新的方法融合，这种方法可以真正被描述为“创新”。该提案中的医疗合作者位于著名的Sansum医学研究所，该研究所距离加州大学圣巴巴拉校区不到10英里。人员交流将得到促进，允许该项目支持的学生和博士后在项目期间在研究所和大学工作。

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.