Sliding-mode-based controllers for automation of blood glucose concentration for type 1 diabetes

Automated blood glucose regulation for nonlinear model of type-1 diabetic patient under uncertainties: GWOCS type-2 fuzzy approach

Regulating blood glucose level (BGL) for type-1 diabetic patient (T1DP) accurately is very important issue, an uncontrolled BGL outside the standard safe range between 70 and 180 mg/dl results in dire consequences for health and can significantly increase the chance of death. So the purpose of this study is to design an optimized controller that infuses appropriate amounts of exogenous insulin into the blood stream of T1DP proportional to the amount of obtained glucose from food. The nonlinear extended Bergman minimal model is used to present glucose-insulin physiological system, an interval type-2 fuzzy logic controller (IT2FLC) is utilized to infuse the proper amount of exogenous insulin. Superiority of IT2FLC in minimizing the effect of uncertainties in the system depends primarily on the best choice of footprint of uncertainty (FOU) of IT2FLC. So a comparison includes four different optimization methods for tuning FOU including hybrid grey wolf optimizer-cuckoo search (GWOCS) and fuzzy logic controller (FLC) method is constructed to select the best controller approach. The effectiveness of the proposed controller was evaluated under six different scenarios of T1DP using Matlab/Simulink platform. A 24-h scenario close to real for 100 virtual T1DPs subjected to parametric uncertainty, uncertain meal disturbance and random initial condition showed that IT2FLC accurately regulate BGL for all T1DPs within the standard safe range. The results indicated that IT2FLC using GWOCS can prevent side effect of treatment with blood-sugar-lowering medication. Also stability analysis for the system indicated that the system operates within the stability region of nonlinear system.

Optimized type-2 fuzzy controller based on IoMT for stabilizing the glucose level in type-1 diabetic patients

Due to advancements in existing Internet of Medical Things (IoMT) systems and devices, the blood glucose level (BGL) for type-1 diabetic patients (T1DPs) is effectively and continually monitored and controlled by Artificial Pancreas. Because the regulation of BGL is a very complex process, many efforts have been conducted to design a powerful and effective controller for the exogenous insulin infusion system. The main objective of this study is to propose an optimized interval type-2 fuzzy (IT2F) based controller of artificial pancreas for regulation BGL of T1DP based on IoMT. The proposed controller should avoid the risk of hyperglycemia and hypoglycemia situations that T1DP faces during the infusion of exogenous insulin. The main contribution of this work is using meta-heuristic method called grey wolf optimizer (GWO) to tune the footprint of uncertainty for IT2F's membership functions to inject the proper dose of insulin under different conditions. The nonlinear extended Bergman minimal model (EBMM) with uncertainty is used to represent the blood glucose regulation and represent the dynamics of meal disturbance in T1DP. The effectiveness and the performance of the proposed controller are investigated using MATLAB/Simulink platform. Simulation results show that the proposed controller can avoid both severe hypoglycemia and hyperglycemia for nominal parameters of the model, in addition to model under the presence of both parametric uncertainty and uncertain meal disturbance.

Intelligent Control with Artificial Neural Networks for Automated Insulin Delivery Systems

Type 1 diabetes mellitus is a disease that affects millions of people around the world. Recent progress in embedded devices has allowed the development of artificial pancreas that can pump insulin subcutaneously to automatically regulate blood glucose levels in diabetic patients. In this work, a Lyapunov-based intelligent controller using artificial neural networks is proposed for application in automated insulin delivery systems. The adoption of an adaptive radial basis function network within the control scheme allows regulation of blood glucose levels without the need for a dynamic model of the system. The proposed model-free approach does not require the patient to inform when they are going to have a meal and is able to deal with inter- and intrapatient variability. To ensure safe operating conditions, the stability of the control law is rigorously addressed through a Lyapunov-like analysis. In silico analysis using virtual patients are provided to demonstrate the effectiveness of the proposed control scheme, showing its ability to maintain normoglycemia in patients with type 1 diabetes mellitus. Three different scenarios were considered: one long- and two short-term simulation studies. In the short-term analyses, 20 virtual patients were simulated for a period of 7 days, with and without prior basal therapy, while in the long-term simulation, 1 virtual patient was assessed over 63 days. The results show that the proposed approach was able to guarantee a time in the range above 95% for the target glycemia in all scenarios studied, which is in fact well above the desirable 70%. Even in the long-term analysis, the intelligent control scheme was able to keep blood glucose metrics within clinical care standards: mean blood glucose of 119.59 mg/dL with standard deviation of 32.02 mg/dL and coefficient of variation of 26.78%, all below the respective reference values.