Artificial Pancreas System With Unannounced Meals Based on a Disturbance Observer and Feedforward Compensation

[EN] This brief is focused on the closed-loop control of postprandial glucose levels of patients with type 1 diabetes mellitus after unannounced meals, which is still a major challenge toward a fully autonomous artificial pancreas. The main limitations are the delays introduced by the subcutaneous i...

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Bibliographic Details
Authors: Sanz Diaz, Ricardo, García Gil, Pedro José|||0000-0002-1202-1269, Diez, José-Luís|||0000-0002-5659-1212, Bondía Company, Jorge|||0000-0001-7286-3719
Format: article
Publication Date:2021
Country:España
Institution:Universitat Politècnica de València (UPV)
Repository:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Language:English
OAI Identifier:oai:riunet.upv.es:10251/171219
Online Access:https://riunet.upv.es/handle/10251/171219
Access Level:Open access
Keyword:Insulin
Sugar
Adaptation models
Mathematical model
Feedforward systems
Diabetes
Pancreas
Artificial pancreas (AP)
Disturbance observer (DOB)
Feedforward compensation
Type 1 diabetes
INGENIERIA DE SISTEMAS Y AUTOMATICA
Description
Summary:[EN] This brief is focused on the closed-loop control of postprandial glucose levels of patients with type 1 diabetes mellitus after unannounced meals, which is still a major challenge toward a fully autonomous artificial pancreas. The main limitations are the delays introduced by the subcutaneous insulin pharmacokinetics and the glucose sensor, which typically leads to insulin overdelivery. Current solutions reported in the literature typically resort to meal announcement, which requires patient intervention. In this brief, a disturbance observer (DOB) is used to estimate the effect of unannounced meals, and the insulin pharmacokinetics is taken into account by means of a feedforward compensator. The proposed strategy is validated in silico with the UVa/Padova metabolic simulator. It is demonstrated how the DOB successfully estimates and counteracts not only the effect of meals but also the sudden drops in the glucose levels that may lead to hypoglycemia. For unannounced meals, results show a median time-in-range of 80% in a 30-day scenario with high carbohydrate content and large intrasubject variability. Optionally, users may decide to announce meals. In this case, considering severe bolus mismatch due to carbohydrate counting errors, the median time-in-range is increased up to 88%. In every case, hypoglycemia is avoided.