A semi‐closed loop computer‐assisted insulin infusion system

Closed loop insulin delivery systems are impractical for widespread hospital use. Thus, a semi‐closed loop computer‐assisted insulin infusion system (CAIIS) was developed for the intravenous delivery of insulin. In its basal program, insulin delivery is determined by blood glucose measurements at intervals of three hours, while the open‐loop meal program delivers 7.5 units over three hours. Control of meal‐induced hyperglycaemia was satisfactory in six subjects with diabetes tested over two to four days, as was mean glycaemic control in the four non‐obese subjects (7.1$pM0.8 mmol/L). To allow for variations in insulin sensitivity, an adjustment incrementing or decrementing the basal insulin delivery rate was applied according to the progressive blood glucose response. Empirical use of this adjustment resulted in good control (mean blood glucose level, 4.1—7.5 mmol/L) in 10 additional subjects with diabetes. This study demonstrates the potential usefulness of a semi‐closed loop insulin infusion system.

[1]  S. Genuth.  Plasma insulin and glucose profiles in normal, obese, and diabetic persons. , 1973, Annals of internal medicine.

[2]  A H Clemens,et al.  Closed-loop and Open-loop Devices for Blood Glucose Control in Normal and Diabetic Subjects , 1978, Diabetes.

[3]  D L Horwitz,et al.  Determination of Free and Total Insulin and C-Peptide in Insulin-treated Diabetics , 1977, Diabetes.

[4]  E. Kraegen,et al.  Carrier solutions for low-level intravenous insulin infusion. , 1975, British medical journal.

[5]  E. Kraegen,et al.  Timing of Insulin Delivery with Meals , 1981, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[6]  E. Joslin,et al.  Joslin's Diabetes Mellitus , 1971 .

[7]  P. Watkins,et al.  Mini-pump: method of diabetic control during minor surgery under general anaesthesia. , 1980, British medical journal.

[8]  M. Rendell,et al.  The Dawn Phenomenon, an Early Morning Glucose Rise: Implications for Diabetic Intraday Blood Glucose Variation , 1981, Diabetes Care.

[9]  C. R. Morgan,et al.  Immunoassay of Insulin Using a Two-Antibody System.∗ , 1962, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.