Artificial pancreas: Evaluating the ARG algorithm without meal announcement

Autores
Fushimi, Emilia; Colmegna, Patricio Hernán; de Battista, Hernán; Garelli, Fabricio; Sanchez Peña, Ricardo Salvador
Año de publicación
2019
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Either under standard basal-bolus treatment or hybrid closed-loop control, subjects with type 1 diabetes are required to count carbohydrates (CHOs). However, CHO counting is not only burdensome but also prone to errors. Recently, an artificial pancreas algorithm that does not require premeal insulin boluses—the so-called automatic regulation of glucose (ARG)—was introduced. In its first pilot clinical study, although the exact CHO counting was not required, subjects still needed to announce the meal time and classify the meal size. Method: An automatic switching signal generator (SSG) is proposed in this work to remove the manual mealtime announcement from the control strategy. The SSG is based on a Kalman filter and works with continuous glucose monitoring readings only. Results: The ARG algorithm with unannounced meals (ARGum) was tested in silico under the effect of different types of mixed meals and intrapatient variability, and contrasted with the ARG algorithm with announced meals (ARGam). Simulations reveal that, for slow-absorbing meals, the time in the euglycemic range, [70-180] mg/dL, increases using the unannounced strategy (ARGam: 78.1 [68.6-80.2]% (median [IQR]) and ARGum: 87.8 [84.5-90.6]%), while similar results were found with fastabsorbing meals (ARGam: 87.4 [86.0-88.9]% and ARGum: 87.6 [86.1-88.8]%). On the other hand, when intrapatient variability is considered, time in euglycemia is also comparable (ARGam: 81.4 [75.4-83.5]% and ARGum: 80.9 [77.0-85.1]%). Conclusion: In silico results indicate that it is feasible to perform an in vivo evaluation of the ARG algorithm with unannounced meals.
Fil: Fushimi, Emilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; Argentina
Fil: Colmegna, Patricio Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Virginia; Estados Unidos. Universidad Nacional de Quilmes; Argentina
Fil: de Battista, Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; Argentina
Fil: Garelli, Fabricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; Argentina
Fil: Sanchez Peña, Ricardo Salvador. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes; Argentina
Materia
ARTIFICIAL PANCREAS
CARBOHYDRATE COUNTING
SLIDING MODE CONTROL
SWITCHED CONTROL
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/121227
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/121227
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Artificial pancreas: Evaluating the ARG algorithm without meal announcementFushimi, EmiliaColmegna, Patricio Hernánde Battista, HernánGarelli, FabricioSanchez Peña, Ricardo SalvadorARTIFICIAL PANCREASCARBOHYDRATE COUNTINGSLIDING MODE CONTROLSWITCHED CONTROLhttps://purl.org/becyt/ford/2.2https://purl.org/becyt/ford/2Background: Either under standard basal-bolus treatment or hybrid closed-loop control, subjects with type 1 diabetes are required to count carbohydrates (CHOs). However, CHO counting is not only burdensome but also prone to errors. Recently, an artificial pancreas algorithm that does not require premeal insulin boluses—the so-called automatic regulation of glucose (ARG)—was introduced. In its first pilot clinical study, although the exact CHO counting was not required, subjects still needed to announce the meal time and classify the meal size. Method: An automatic switching signal generator (SSG) is proposed in this work to remove the manual mealtime announcement from the control strategy. The SSG is based on a Kalman filter and works with continuous glucose monitoring readings only. Results: The ARG algorithm with unannounced meals (ARGum) was tested in silico under the effect of different types of mixed meals and intrapatient variability, and contrasted with the ARG algorithm with announced meals (ARGam). Simulations reveal that, for slow-absorbing meals, the time in the euglycemic range, [70-180] mg/dL, increases using the unannounced strategy (ARGam: 78.1 [68.6-80.2]% (median [IQR]) and ARGum: 87.8 [84.5-90.6]%), while similar results were found with fastabsorbing meals (ARGam: 87.4 [86.0-88.9]% and ARGum: 87.6 [86.1-88.8]%). On the other hand, when intrapatient variability is considered, time in euglycemia is also comparable (ARGam: 81.4 [75.4-83.5]% and ARGum: 80.9 [77.0-85.1]%). Conclusion: In silico results indicate that it is feasible to perform an in vivo evaluation of the ARG algorithm with unannounced meals.Fil: Fushimi, Emilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; ArgentinaFil: Colmegna, Patricio Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Virginia; Estados Unidos. Universidad Nacional de Quilmes; ArgentinaFil: de Battista, Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; ArgentinaFil: Garelli, Fabricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; ArgentinaFil: Sanchez Peña, Ricardo Salvador. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes; ArgentinaSAGE Publications Inc.2019-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttp://hdl.handle.net/11336/121227Fushimi, Emilia; Colmegna, Patricio Hernán; de Battista, Hernán; Garelli, Fabricio; Sanchez Peña, Ricardo Salvador; Artificial pancreas: Evaluating the ARG algorithm without meal announcement; SAGE Publications Inc.; Journal of Diabetes Science and Technology; 13; 6; 7-2019; 1035-10431932-2968CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://journals.sagepub.com/doi/10.1177/1932296819864585info:eu-repo/semantics/altIdentifier/doi/10.1177/1932296819864585info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:18:37Zoai:ri.conicet.gov.ar:11336/121227instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:18:37.226CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Artificial pancreas: Evaluating the ARG algorithm without meal announcement
title Artificial pancreas: Evaluating the ARG algorithm without meal announcement
spellingShingle Artificial pancreas: Evaluating the ARG algorithm without meal announcement
Fushimi, Emilia
ARTIFICIAL PANCREAS
CARBOHYDRATE COUNTING
SLIDING MODE CONTROL
SWITCHED CONTROL
title_short Artificial pancreas: Evaluating the ARG algorithm without meal announcement
title_full Artificial pancreas: Evaluating the ARG algorithm without meal announcement
title_fullStr Artificial pancreas: Evaluating the ARG algorithm without meal announcement
title_full_unstemmed Artificial pancreas: Evaluating the ARG algorithm without meal announcement
title_sort Artificial pancreas: Evaluating the ARG algorithm without meal announcement
dc.creator.none.fl_str_mv Fushimi, Emilia
Colmegna, Patricio Hernán
de Battista, Hernán
Garelli, Fabricio
Sanchez Peña, Ricardo Salvador
author Fushimi, Emilia
author_facet Fushimi, Emilia
Colmegna, Patricio Hernán
de Battista, Hernán
Garelli, Fabricio
Sanchez Peña, Ricardo Salvador
author_role author
author2 Colmegna, Patricio Hernán
de Battista, Hernán
Garelli, Fabricio
Sanchez Peña, Ricardo Salvador
author2_role author
author
author
author
dc.subject.none.fl_str_mv ARTIFICIAL PANCREAS
CARBOHYDRATE COUNTING
SLIDING MODE CONTROL
SWITCHED CONTROL
topic ARTIFICIAL PANCREAS
CARBOHYDRATE COUNTING
SLIDING MODE CONTROL
SWITCHED CONTROL
purl_subject.fl_str_mv https://purl.org/becyt/ford/2.2
https://purl.org/becyt/ford/2
dc.description.none.fl_txt_mv Background: Either under standard basal-bolus treatment or hybrid closed-loop control, subjects with type 1 diabetes are required to count carbohydrates (CHOs). However, CHO counting is not only burdensome but also prone to errors. Recently, an artificial pancreas algorithm that does not require premeal insulin boluses—the so-called automatic regulation of glucose (ARG)—was introduced. In its first pilot clinical study, although the exact CHO counting was not required, subjects still needed to announce the meal time and classify the meal size. Method: An automatic switching signal generator (SSG) is proposed in this work to remove the manual mealtime announcement from the control strategy. The SSG is based on a Kalman filter and works with continuous glucose monitoring readings only. Results: The ARG algorithm with unannounced meals (ARGum) was tested in silico under the effect of different types of mixed meals and intrapatient variability, and contrasted with the ARG algorithm with announced meals (ARGam). Simulations reveal that, for slow-absorbing meals, the time in the euglycemic range, [70-180] mg/dL, increases using the unannounced strategy (ARGam: 78.1 [68.6-80.2]% (median [IQR]) and ARGum: 87.8 [84.5-90.6]%), while similar results were found with fastabsorbing meals (ARGam: 87.4 [86.0-88.9]% and ARGum: 87.6 [86.1-88.8]%). On the other hand, when intrapatient variability is considered, time in euglycemia is also comparable (ARGam: 81.4 [75.4-83.5]% and ARGum: 80.9 [77.0-85.1]%). Conclusion: In silico results indicate that it is feasible to perform an in vivo evaluation of the ARG algorithm with unannounced meals.
Fil: Fushimi, Emilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; Argentina
Fil: Colmegna, Patricio Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. University of Virginia; Estados Unidos. Universidad Nacional de Quilmes; Argentina
Fil: de Battista, Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; Argentina
Fil: Garelli, Fabricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales. Universidad Nacional de La Plata. Instituto de Investigaciones en Electrónica, Control y Procesamiento de Señales; Argentina
Fil: Sanchez Peña, Ricardo Salvador. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Quilmes; Argentina
description Background: Either under standard basal-bolus treatment or hybrid closed-loop control, subjects with type 1 diabetes are required to count carbohydrates (CHOs). However, CHO counting is not only burdensome but also prone to errors. Recently, an artificial pancreas algorithm that does not require premeal insulin boluses—the so-called automatic regulation of glucose (ARG)—was introduced. In its first pilot clinical study, although the exact CHO counting was not required, subjects still needed to announce the meal time and classify the meal size. Method: An automatic switching signal generator (SSG) is proposed in this work to remove the manual mealtime announcement from the control strategy. The SSG is based on a Kalman filter and works with continuous glucose monitoring readings only. Results: The ARG algorithm with unannounced meals (ARGum) was tested in silico under the effect of different types of mixed meals and intrapatient variability, and contrasted with the ARG algorithm with announced meals (ARGam). Simulations reveal that, for slow-absorbing meals, the time in the euglycemic range, [70-180] mg/dL, increases using the unannounced strategy (ARGam: 78.1 [68.6-80.2]% (median [IQR]) and ARGum: 87.8 [84.5-90.6]%), while similar results were found with fastabsorbing meals (ARGam: 87.4 [86.0-88.9]% and ARGum: 87.6 [86.1-88.8]%). On the other hand, when intrapatient variability is considered, time in euglycemia is also comparable (ARGam: 81.4 [75.4-83.5]% and ARGum: 80.9 [77.0-85.1]%). Conclusion: In silico results indicate that it is feasible to perform an in vivo evaluation of the ARG algorithm with unannounced meals.
publishDate 2019
dc.date.none.fl_str_mv 2019-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/121227
Fushimi, Emilia; Colmegna, Patricio Hernán; de Battista, Hernán; Garelli, Fabricio; Sanchez Peña, Ricardo Salvador; Artificial pancreas: Evaluating the ARG algorithm without meal announcement; SAGE Publications Inc.; Journal of Diabetes Science and Technology; 13; 6; 7-2019; 1035-1043
1932-2968
CONICET Digital
CONICET
url http://hdl.handle.net/11336/121227
identifier_str_mv Fushimi, Emilia; Colmegna, Patricio Hernán; de Battista, Hernán; Garelli, Fabricio; Sanchez Peña, Ricardo Salvador; Artificial pancreas: Evaluating the ARG algorithm without meal announcement; SAGE Publications Inc.; Journal of Diabetes Science and Technology; 13; 6; 7-2019; 1035-1043
1932-2968
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://journals.sagepub.com/doi/10.1177/1932296819864585
info:eu-repo/semantics/altIdentifier/doi/10.1177/1932296819864585
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/vnd.openxmlformats-officedocument.wordprocessingml.document
application/pdf
dc.publisher.none.fl_str_mv SAGE Publications Inc.
publisher.none.fl_str_mv SAGE Publications Inc.
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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