Incorporating Prior Information in Adaptive Model Predictive Control for Multivariable Artificial Pancreas Systems

Background: Adaptive model predictive control (MPC) algorithms that recursively update the glucose prediction model are shown to be promising in the development of fully automated multivariable artificial pancreas systems. However, the recursively updated glycemic prediction models do not explicitly consider prior knowledge in the identification of the model parameters. Prior information of the glycemic effects of meals and physical activity can improve model accuracy and yield better glycemic control algorithms. Methods: A glucose prediction model based on regularized partial least squares (rPLS) method where the prior information is encoded as the regularization term is developed to provide accurate predictions of the future glucose concentrations. An adaptive MPC is developed that incorporates dynamic trajectories for the glucose setpoint and insulin dosing constraints based on the estimated plasma insulin concentration (PIC). The proposed adaptive MPC algorithm is robust to disturbances caused by unannounced meals and physical activities even in cases with missing glucose measurements. The effectiveness of the proposed adaptive MPC based on rPLS is investigated with in silico subjects of the multivariable glucose-insulin-physiological variables simulator (mGIPsim). Results: The efficacy of the proposed adaptive MPC strategy in regulating the blood glucose concentration (BGC) of people with T1DM is assessed using the average percent time in range (TIR) for glucose, defined as 70 to 180 mg/dL inclusive, and the average percent time in hypoglycemia (<70 and >54 mg/dL) and level 2 hypoglycemia (≤54 mg/dL). The TIR for a cohort of 20 virtual subjects of mGIPsim is 81.9% ± 7.4% (with no hypoglycemia or severe hypoglycemia) for the proposed MPC compared with 73.9% ± 7.6% (0.2% ± 0.1% in hypoglycemia and 0.1% ± 0.1% in level 2 hypoglycemia) for an MPC based on a recursive autoregressive exogenous (ARX) model. Conclusions: The adaptive MPC algorithm that incorporates prior knowledge in the recursive updating of the glucose prediction model can contribute to the development of fully automated artificial pancreas systems that can mitigate meal and physical activity disturbances.

90% Accuracy for Photoplethysmography-Based Non-Invasive Blood Glucose Prediction by Deep Learning with Cohort Arrangement and Quarterly Measured HbA1c

Previously published photoplethysmography-(PPG) based non-invasive blood glucose (NIBG) measurements have not yet been validated over 500 subjects. As illustrated in this work, we increased the number subjects recruited to 2538 and found that the prediction accuracy (the ratio in zone A of Clarke’s error grid) reduced to undesirable 60.6%. We suspect the low prediction accuracy induced by larger sample size might arise from the physiological diversity of subjects, and one possibility is that the diversity might originate from medication. Therefore, we split the subjects into two cohorts for deep learning: with and without medication (1682 and 856 recruited subjects, respectively). In comparison, the cohort training for subjects without any medication had approximately 30% higher prediction accuracy over the cohort training for those with medication. Furthermore, by adding quarterly (every 3 months) measured glycohemoglobin (HbA1c), we were able to significantly boost the prediction accuracy by approximately 10%. For subjects without medication, the best performing model with quarterly measured HbA1c achieved 94.3% prediction accuracy, RMSE of 12.4 mg/dL, MAE of 8.9 mg/dL, and MAPE of 0.08, which demonstrates a very promising solution for NIBG prediction via deep learning. Regarding subjects with medication, a personalized model could be a viable means of further investigation.

Predictive Glucose Monitoring for People with Diabetes Using Wearable Sensors

Diabetes is a chronic non-communicable disease resulting from pancreatic inability to produce the hormone insulin, or a physiological cellular inability to use this hormone effectively. This leads to unregulated blood glucose levels, which can cause significant and often irreversible physiological damage. Current means of glucose level monitoring range from infrequent capillary blood glucose sampling to continuous interstitial fluid glucose monitoring. However, the accuracy of these methods is limited by numerous factors. A potential solution to this shortcoming involves the use of wearable sensors that record an individual’s physiological responses to a range of daily activities, which are subsequently fused and processed with machine learning (ML) algorithms to provide a prediction of an individual’s glucose level and can provide an artificial intelligence-driven glucose monitoring platform. In this paper, we conduct a comparison case study using quadratic discriminant analysis (QDA) and support vector machine (SVM) algorithms for the classification of glucose levels with data acquired from the wearable sensors of a type 1 diabetic individual. Preliminary results demonstrate predicted glucose levels with >70% accuracy, indicating potential for this approach to be used in the design of an ergonomic glucose prediction platform utilizing wearable sensors. Further work will involve the exploration of additional datasets from affordable wearables to enhance and improve the prediction power of the ML algorithms.