New microprocessor-based insulin controller

Artificial Pancreas Control Strategies Used for Type 1 Diabetes Control and Treatment: A Comprehensive Analysis

This paper presents a comprehensive survey about the fundamental components of the artificial pancreas (AP) system including insulin administration and delivery, glucose measurement (GM), and control strategies/algorithms used for type 1 diabetes mellitus (T1DM) treatment and control. Our main focus is on the T1DM that emerges due to pancreas’s failure to produce sufficient insulin due to the loss of beta cells (β-cells). We discuss various insulin administration and delivery methods including physiological methods, open-loop, and closed-loop schemes. Furthermore, we report several factors such as hyperglycemia, hypoglycemia, and many other physical factors that need to be considered while infusing insulin in human body via AP systems. We discuss three prominent control algorithms including proportional-integral- derivative (PID), fuzzy logic, and model predictive, which have been clinically evaluated and have all shown promising results. In addition, linear and non-linear insulin infusion control schemes have been formally discussed. To the best of our knowledge, this is the first work which systematically covers recent developments in the AP components with a solid foundation for future studies in the T1DM field.

Application of computers in diabetes care--a review. II. Computers for decision support and education

This paper concludes a review of the contribution of information technology to diabetes care. The role of decision support tools for planning insulin therapy using various clinical algorithms, knowledge-based approaches and interactive simulations is discussed, and certain telemedicine approaches to therapy are considered. The validation and clinical evaluation of these tools is reviewed, as is the likely impact of the routine clinical application of implantable/non-invasive blood glucose monitoring devices. Finally, the application of computers as teaching tools is considered, and ways in which such educational approaches might be applied for disseminating the benefits of the Diabetes Control and Complications Trial more widely are discussed.

Intermediary metabolism in diabetic dogs treated with pancreatic autotransplants and insulin pumps

Diurnal metabolite profiles were studied in pancreatectomized dogs who had received grafts of their own pancreas. The results were compared to similarly diabetic animals who received exogenous insulin pumped intravenously either peripherally or portally. All animals were studied at least 52 weeks after pancreatectomy. Nondiabetic animals were similarly studied as normal controls. Interestingly, all of the diabetic animals were in excellent metabolic control but significant differences from normal in one or more of the metabolic variables existed in each group. Thus, none of the methods of insulin replacement entirely restored to normal the metabolic state of the pancreatectomized dogs. For example, in the autotransplanted animals, the profiles of glucose, lactate, pyruvate, and alanine manifested either abnormal levels and/or abnormal postprandial excursions. The grafts delivered insulin into the peripheral rather than portal circulations. In the peripherally infused animals, the profiles of pyruvate, alanine, and free fatty acids were also somewhat abnormal. In the portally infused animals the profiles only of pyruvate and alanine showed minor abnormalities without clear statistical significance in some respects as well. The other differences observed were statistically significant (P less than 0.05-0.01). These results suggest that the portal route of insulin delivery may be the route of choice if intermediary metabolism is to approximate normal most closely whether exogenous intravenous insulin is replaced by implanted pumps or endogenous insulin is replaced by pancreatic transplants and that none of these futuristic methods of insulin replacement entirely restore to normal the metabolic state of pancreatectomized dogs.