Control Systems for Artificial Pancreas Use During and After Exercise

描述(申请人提供)：1型糖尿病患者希望享受无忧无虑和积极的生活方式，进行体育活动和锻炼计划。人工胰腺(AP)不需要手动输入，例如病人的饮食或体力活动信息，可以满足这些愿望。研究开发AP系统可以控制患者在体力活动期间的血糖水平非常重要，因为许多患者将日常体力活动作为调节血糖浓度的重要因素，并参与显著改变其血糖水平的个人和/或团体运动。此外，在几项高强度运动中的活动模式类似于儿童游戏和在 建议的工作将更有利于孩子们的无忧无虑的游戏。到目前为止，很少有研究小组尝试在锻炼环境中测试他们的AP技术，也没有一个专注于检查不同类型的活动。对于1型糖尿病患者来说，在各种类型的运动期间和之后使用具有适当控制和低血糖预警系统的AP都是安全和有效的。与目前可用的胰岛素治疗方法(持续皮下注射胰岛素或每天多次注射)相比，这项技术将极大地减少低血糖事件的数量和持续时间。这样的AP系统只能通过使用复杂的多变量方法来开发，该方法包括葡萄糖浓度和一些影响葡萄糖稳态的生理变量，如能量消耗。我们的多变量递归建模和自适应控制框架提供了适当的设置，以实现在几种类型的体育活动期间和之后有效的AP系统 在能量支出和用于支持这一支出的新陈代谢系统(即有氧、无氧和混合活动、团队运动)方面存在显著差异。建议的AP使用特定于患者的递归动态模型，该模型通过皮下血糖测量和生理数据预测血糖浓度，低血糖早期预警系统，以及基于这些模型的自适应控制器来计算胰岛素输注率。该项目的目标是为糖尿病患者开发在各种运动和集体运动期间和之后使用将是安全的AP的多变量控制和低血糖预警系统，开发一个多变量模拟系统来模拟不同类型运动对血糖水平变化的影响并测试开发的算法，以评估AP系统在临床研究中心和糖尿病运动营地的临床研究中的性能，以及确定为改变对低血糖的恐惧、生活质量和治疗满意度而开发的AP系统的影响。

DESCRIPTION (provided by applicant): Patients with type 1 diabetes would like to enjoy carefree and active lifestyles, conduct physical activities and exercise programs. An artificial pancreas (AP) that does not necessitate manual inputs such as meal or physical activity information from the patient can accommodate these wishes. Research on the development of AP systems that can control blood glucose levels during the physical activities of patients is important because many patients use daily physical activity as an important element of regulating their blood glucose concentrations and participate in individual and/or group sports that dramatically change their blood glucose levels. Also, the activity patterns in several sports with bursts of high-intensity efforts are similar to children's play and the AP system developed in the proposed work will be more conducive to the carefree play of children. To date, few research groups have attempted to test their AP technologies in an environment of exercise and none have focused on the examination of different types of activity. An AP with properly developed control and hypoglycemia early-warning systems can be safe and effective to use both during and after a variety of types of exercise for patients with type 1 diabetes. This technology will dramatically reduce the number and duration of hypoglycemic events, as compared to the currently available methods of insulin therapy (continuous subcutaneous insulin infusions or multiple daily injections). Such AP systems can only be developed by using a sophisticated multivariable approach that includes glucose concentrations and a number of physiological variables that impact glucose homeostasis such as energy expenditure. Our multivariable recursive modeling and adaptive control framework provides the proper setting to achieve AP systems that are effective during and after several of types of physical activities that differ markedly in energy expenditures and the metabolic systems used to support that expenditure (i.e. aerobic, anaerobic, and mixed activities, team sports). The proposed AP uses patient-specific recursive dynamic models that predict blood glucose concentrations by using subcutaneous glucose measurements and physiological data, early warning systems for hypoglycemia, and adaptive controllers based on these models to calculate insulin infusion rates. The project aims are to develop multivariable control and hypoglycemia early warning systems for APs that will be safe to use during and after various types of exercise and group sports for patients with diabetes, to develop a multivariable simulation system to simulate the effects of different types of exercise on variations in blood glucose levels and test the algorithm developed, to assess the performance of the AP system in clinical studies at Clinical Research Centers and diabetes sports camps and to determine the impact of the AP system developed for changes in fear of hypoglycemia, quality of life, and treatment satisfaction.