Comparison of Algorithms for the Closed-Loop Control of Blood Glucose Using the Artificial Beta Cell

Over the past 15 years, several algorithms have been proposed and used for closed-loop blood glucose regulation. Their intent is to artificially replace the normal responses of the pancreatic beta cell absent in insulin-dependent diabetes. All of these algorithms calculate insulin infusion rates on the basis of minute-by-minute measurements of whole blood glucose concentration and its calculated rate of rise or fall. In addition, various techniques are employed to compensate for measurement delay time and the presence of noise in the measured signals. The goal of these feedback systems is to normalize blood glucose in diabetes mellitus. Interestingly, some recently "optimized" versions provide only a near normalization of glycemia in patients with insulin-dependent diabetes, a degree ofglycemic control which is not significantly different from intensified conventional insulin therapy.

[1]  A H Clemens,et al.  The artificial beta cell--a continuous control of blood sugar by external regulation of insulin infusion (glucose controlled insulin infusion system). , 1974, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[2]  A M Albisser,et al.  Glycemic Regulation Using a Programmed Insulin Delivery Device: III. Long-Term Studies on Diabetic Dogs , 1979, Diabetes.

[3]  A. H. Kadish,et al.  AUTOMATION CONTROL OF BLOOD SUGAR. I. A SERVOMECHANISM FOR GLUCOSE MONITORING AND CONTROL. , 1964, The American journal of medical electronics.

[4]  M. T. Brennan,et al.  Insulin secretion in response to glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus. , 1967, The Journal of clinical investigation.

[5]  W. Zingg,et al.  An Artificial Endocrine Pancreas , 1974, Diabetes.

[6]  G. Grodsky,et al.  Dynamics of insulin secretion by the perfused rat pancreas. , 1968, Endocrinology.

[7]  W. F. Taylor,et al.  Mean Amplitude of Glycemic Excursions, a Measure of Diabetic Instability , 1970, Diabetes.

[8]  Y. Yamasaki,et al.  Importance of insulin secretion based on the rate of change in blood glucose concentration in glucose tolerance, assessed by the artificial beta cell. , 1978, Acta endocrinologica.

[9]  B. Zinman,et al.  Normalization of Glycemia in Diabetics During Meals with Insulin and Glucagon Delivery by the Artificial Pancreas , 1977, Diabetes.

[10]  Charles K. Botz.  An Improved Control Algorithm for an Artificial ß-Cell , 1976, IEEE Transactions on Biomedical Engineering.

[11]  A. Albisser,et al.  An improved technique for the rapid continuous measurement of whole blood glucose, suitable for clinical application in an artificial endocrine pancreas. , 1977, Medical progress through technology.

[12]  J. Schlichtkrull,et al.  [M-VALUE, AN INDEX FOR BLOOD SUGAR CONTROL IN DIABETICS]. , 1964, Ugeskrift for laeger.

[13]  B. Zinman,et al.  Insulinoma Resection Facilitated by the Artificial Endocrine Pancreas , 1978, Diabetes.

[14]  A. Albisser,et al.  Devices for the control of diabetes mellitus , 1979, Proceedings of the IEEE.

[15]  W Kerner,et al.  Attempts at perfect normalization of glucose tolerance test of severe diabetics by artificial beta cell. , 1976, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[16]  W Zingg,et al.  Clinical Control of Diabetes by the Artificial Pancreas , 1974, Diabetes.

[17]  A H Clemens,et al.  The development of Biostator, a Glucose Controlled Insulin Infusion System (GCIIS). , 1977, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[18]  E. Kraegen,et al.  Control of blood glucose in diabetics using an artificial pancreas. , 1977, Australian and New Zealand journal of medicine.

[19]  A H Clemens,et al.  Control of blood sugar in insulin-dependent diabetes: comparison of an artificial endocrine pancreas, continuous subcutaneous insulin infusion, and intensified conventional insulin therapy. , 1980, The New England journal of medicine.

[20]  U. Fischer,et al.  Derivation and experimental proof of a new algorithm for the artificial B-cell based on the individual analysis of the physiological insulin-glucose relationship. , 1978, Endokrinologie.

[21]  Clemens Ah,et al.  Feedback control dynamics for glucose controlled insulin infusion system. , 1979 .