Using meta-differential evolution to enhance a calculation of a continuous blood glucose level

Distributed Assessment of Virtual Insulin-Pump Settings Using SmartCGMS and DMMS.R for Diabetes Treatment

Diabetes is a heterogeneous group of diseases that share a common trait of elevated blood glucose levels. Insulin lowers this level by promoting glucose utilization, thus avoiding short- and long-term organ damage due to the elevated blood glucose level. A patient with diabetes uses an insulin pump to dose insulin. The pump uses a controller to compute and dose the correct amount of insulin to keep blood glucose levels in a safe range. Insulin-pump controller development is an ongoing process aiming at fully closed-loop control. Controllers entering the market must be evaluated for safety. We propose an evaluation method that exploits an FDA-approved diabetic patient simulator. The method evaluates a Cartesian product of individual insulin-pump parameters with a fine degree of granularity. As this is a computationally intensive task, the simulator executes on a distributed cluster. We identify safe and risky combinations of insulin-pump parameter settings by applying the binomial model and decision tree to this product. As a result, we obtain a tool for insulin-pump settings and controller safety assessment. In this paper, we demonstrate the tool with the Low-Glucose Suspend and OpenAPS controllers. For average ± standard deviation, LGS and OpenAPS exhibited 1.7 ± 0.6% and 3.2 ± 1.8% of local extrema (i.e., good insulin-pump settings) out of all the entire Cartesian products, respectively. A continuous region around the best-discovered settings (i.e., the global extremum) of the insulin-pump settings spread across 4.0 ± 1.1% and 4.1 ± 1.3% of the Cartesian products, respectively.

Adaptive Differential Evolution Algorithm Based on Fitness Landscape Characteristic

Differential evolution (DE) is a simple, effective, and robust algorithm, which has demonstrated excellent performance in dealing with global optimization problems. However, different search strategies are designed for different fitness landscape conditions to find the optimal solution, and there is not a single strategy that can be suitable for all fitness landscapes. As a result, developing a strategy to adaptively steer population evolution based on fitness landscape is critical. Motivated by this fact, in this paper, a novel adaptive DE based on fitness landscape (FL-ADE) is proposed, which utilizes the local fitness landscape characteristics in each generation population to (1) adjust the population size adaptively; (2) generate DE/current-to-pcbest mutation strategy. The adaptive mechanism is based on local fitness landscape characteristics of the population and enables to decrease or increase the population size during the search. Due to the adaptive adjustment of population size for different fitness landscapes and evolutionary processes, computational resources can be rationally assigned at different evolutionary stages to satisfy diverse requirements of different fitness landscapes. Besides, the DE/current-to-pcbest mutation strategy, which randomly chooses one of the top p% individuals from the archive cbest of local optimal individuals to be the pcbest, is also an adaptive strategy based on fitness landscape characteristic. Using the individuals that are approximated as local optimums increases the algorithm’s ability to explore complex multimodal functions and avoids stagnation due to the use of individuals with good fitness values. Experiments are conducted on CEC2014 benchmark test suit to demonstrate the performance of the proposed FL-ADE algorithm, and the results show that the proposed FL-ADE algorithm performs better than the other seven highly performing state-of-art DE variants, even the winner of the CEC2014 and CEC2017. In addition, the effectiveness of the adaptive population mechanism and DE/current-to-pcbest mutation strategy based on landscape fitness proposed in this paper are respectively verified.

Physiological reconstruction of blood glucose level using CGMS-signals only

Patient with diabetes must regularly monitor blood glucose level. Drawing a blood sample is a painful and discomfort experience. Alternatively, the patient measures interstitial fluid glucose level with a sensor installed in subcutaneous tissue. Then, a model of glucose dynamics calculates blood glucose level from the sensor-measured, i.e., interstitial fluid glucose level of subcutaneous tissue. Interstitial fluid glucose level can significantly differ from blood glucose level. The sensor is either factory-calibrated, or the patient calibrates the sensor periodically by drawing blood samples, when glucose levels of both compartments are steady. In both cases, the sensor lifetime is limited up to 14 days. This is the present state of the art. With a physiological model, we would like to prolong the sensor lifetime with an adaptive approach, while requiring no additional blood sample. Prolonging sensor’s lifetime, while reducing the associated discomfort, would considerably improve patient’s quality of life. We demonstrate that it is possible to determine personalized model parameters from multiple CGMS-signals only, using an animal experiment with a hyperglycemic clamp. The experimenter injected separate glucose and insulin boluses to trigger rapid changes, on which we evaluated the ability to react to non-steady glucose levels in different compartments. With the proposed model, 70%, 80% and 95% of the calculated blood glucose levels had relative error less than or equal to 21.9%, 32.5% and 43.6% respectively. Without the model, accuracy of the sensor-estimated blood glucose level decreased to 39.4%, 49.9% and 99.0% relative errors. This confirms feasibility of the proposed method.