Postprandial response improvement via safety layer in closed-loop blood glucose controllers

LEÓN-VARGAS, F.; GARELLI, F.; DE BATTISTA, H.; VEHÍ, J.

BIOMEDICAL SIGNAL PROCESSING AND CONTROL

ELSEVIER SCI LTD

Lugar: Amsterdam; Año: 2015 vol. 16 p. 80 - 87

1746-8094

Traditional Type 1 diabetes therapies are prone to show poor glucose regulation especially in the postprandial period owing to both physiological and technological limitations. Although a closed-loop controller for glucose regulation has to be tuned to minimize the postprandial excursion and avoid late hypoglycemia, the intrinsic limitations of the problemlead to a trade-off between postprandial peak and late hypoglycemia risk. This paper reveals through an intensive in-silico study with multiple controller tuning combinations that a novel safety layer for glucose controllers, the so-called SAFE loop [1], not only reduces the hypoglycemia events but also allows reducing the postprandial glucose excursion, thus breaking the implicit trade-off present in single controllers. The SAFE outer loop monitors the estimated amount of insulin on board, and modifies the control action if it is close to a unique constraint which can be adjusted with clinical criteria. A very challenging test scenario is here implemented including the rate of blood glucose appearance from intakes of mixed meals, diurnal and day-to-day time-varying metabolic changes, inherent drawbacks in sensor and actuator, and other realistic conditions. The results show a significant reduction of hypoglycemia events when SAFE is added, regardless the closed-loop glucose controller, together with a potential postprandial response improvement.