Chance Constraint Based Design of IV Insulin Control for Type 1 Diabetic Patients Under Model and Meal Uncertainties

Volume 3: Biomedical and Biotechnology Engineering ◽

10.1115/imece2018-87759 ◽

2018 ◽

Author(s):

Souransu Nandi ◽

Tarunraj Singh

Keyword(s):

Blood Glucose ◽

Chance Constraint ◽

Diabetic Patients ◽

Dynamics Model ◽

Unscented Transform ◽

Insulin Control ◽

Mean And Variance ◽

The Mean ◽

Type 1 Diabetic Patients

The focus of this paper is on the development of a chance constrained controller for type 1 diabetic patients in the presence of model, meal and initial condition uncertainty. Since the chance constraints require the mean and variance of the evolving uncertain blood-glucose, a conjugate unscented transform based approach is used to estimate the blood-glucose statistics. The proposed approach is demonstrated on the classic Bergman model augmented with a gut dynamics model.

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Patient-derived Quality Specifications for Instruments Used in Self-Monitoring of Blood Glucose

Clinical Chemistry ◽

10.1093/clinchem/47.1.67 ◽

2001 ◽

Vol 47 (1) ◽

pp. 67-73 ◽

Cited By ~ 51

Author(s):

Svein Skeie ◽

Geir Thue ◽

Sverre Sandberg

Keyword(s):

Blood Glucose ◽

Clinical Situation ◽

Diabetic Patients ◽

Analytical Quality ◽

Self Monitoring ◽

Mean Frequency ◽

Quality Specifications ◽

The Mean ◽

Type 1 Diabetic Patients

Abstract Background: Instruments for self-monitoring of glucose (SMBG) are increasingly used by diabetic patients. Information is limited on how patients use and interpret SMBG results, and no quality specifications for such instruments are based on the opinions of patients. Methods: Type 1 diabetic patients (n = 201) filled in a questionnaire eliciting daily limits for blood glucose (BG) and changes of BG considered significant at different glucose concentrations. From these responses, patient-derived quality specifications were calculated in different clinical situations with low, intermediate, and high BG concentrations. Results: Mean age of the patients was 31.8 years, mean diabetes duration was 14.7 years, and mean SMBG duration was 10.0 years with a mean frequency of 11.2 measurements/week. The threshold for hypoglycemic symptoms was 3.0 mmol/L (54 mg/dL), and the mean daily BG target window was 4.3–10.4 mmol/L (77–187 mg/dL). The mean absolute BG changes producing actions from the patients ranged from 1.1 mmol/L (20 mg/dL) to 3.6 mmol/L (65 mg/dL). The analytical quality specifications for imprecision depended on the clinical situation. Excluding the hypoglycemic situation, the analytical CV needed to fulfill the expectations of 75% of the patients was 6.4–9.7%. The analytical quality specification for CV at hypoglycemic concentrations was 3.1%. Conclusions: Instruments for self-measurements of glucose with an imprecision (CV) of ≤5% and bias ≤5% meet the expectations of >75% of patients in clinical situations other than hypoglycemia.

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Prediction of personalized blood glucose levels in type 1 diabetic patients using a neuroevolution approach

Proceedings of the Genetic and Evolutionary Computation Conference Companion ◽

10.1145/3449726.3463143 ◽

2021 ◽

Author(s):

Ivanoe De Falco ◽

Antonio Della Cioppa ◽

Angelo Marcelli ◽

Umberto Scafuri ◽

Luca Stellaccio ◽

...

Keyword(s):

Blood Glucose ◽

Diabetic Patients ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Type 1 Diabetic Patients

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The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients

European Journal of Ophthalmology ◽

10.1177/1120672121990576 ◽

2021 ◽

pp. 112067212199057

Author(s):

Tomás de Oliveira Loureiro ◽

João Nobre Cardoso ◽

Carlos Diogo Pinheiro Lima Lopes ◽

Ana Rita Carreira ◽

Sandra Rodrigues-Barros ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Metabolic Control ◽

Insulin Pump Therapy ◽

Vascular Density ◽

Diabetic Patients ◽

Retinal Vasculature ◽

Increased Risk ◽

The Mean ◽

Type 1 Diabetic Patients

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.

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