Regulation of Blood Glucose Concentration in Type 1 Diabetics Using Single Order Sliding Mode Control Combined with Fuzzy On-line Tunable Gain, a Simulation Study

In Silico Investigation of SNR and Dermis Sensitivity for Optimum Dual-Channel Near-Infrared Glucose Sensor Designs for Different Skin Colors

Diabetes is a serious health condition that requires patients to regularly monitor their blood glucose level, making the development of practical, compact, and non-invasive techniques essential. Optical glucose sensors-and, specifically, NIR sensors-have the advantages of being non-invasive, compact, inexpensive, and user-friendly devices. However, these sensors have low accuracy and are yet to be adopted by healthcare providers. In our previous work, we introduced a non-invasive dual-channel technique for NIR sensors, in which a long channel is utilized to measure the glucose level in the inner skin (dermis) layer, while a short channel is used to measure the noise signal of the superficial skin (epidermis) layer. In this work, we investigated the use of dual-NIR channels for patients with different skin colors (i.e., having different melanin concentrations). We also adopted a Monte Carlo simulation model that takes into consideration the differences between different skin layers, in terms of blood content, water content, melanin concentration in the epidermis layer, and skin optical proprieties. On the basis of the signal-to-noise ratio, as well as the sensitivities of both the epidermis and dermis layers, we suggest the selection of wavelengths and source-to-detector separation for optimal NIR channels under different skin melanin concentrations. This work facilitates the improved design of a compact and non-invasive NIR glucose sensor that can be utilized by patients with different skin colors.

Terahertz Asymmetric S-Shaped Complementary Metasurface Biosensor for Glucose Concentration

In this article, we present a free-standing terahertz metasurface based on asymmetric S-shaped complementary resonators under normal incidence in transmission mode configuration. Each unit cell of the metasurface consists of two arms of mirrored S-shaped slots. We investigate the frequency response at different geometrical asymmetry via modifying the dimensions of one arm of the resonator. This configuration enables the excitation of asymmetric quasi-bound states in the continuum resonance and, hence, features very good field confinement that is very important for biosensing applications. Moreover, the performance of this configuration as a biosensor was examined for glucose concentration levels from 54 mg/dL to 342 mg/dL. This range covers hypoglycemia, normal, and hyperglycemia diabetes mellitus conditions. Two sample coating scenarios were considered, namely the top layer when the sample covers the metasurface and the top and bottom layers when the metasurface is sandwiched between the two layers. This strategy enabled very large resonance frequency redshifts of 236.1 and 286.6 GHz that were observed for the two scenarios for a 342 mg/dL concentration level and a layer thickness of 20 μm. Furthermore, for the second scenario and the same thickness, a wavelength sensitivity of 322,749 nm/RIU was found, which represents a factor of 2.3 enhancement compared to previous studies. The suggested terahertz metasurface biosensor in this paper could be used in the future for identifying hypoglycaemia and hyperglycemia conditions.

A Review of Non-Invasive Optical Systems for Continuous Blood Glucose Monitoring

The prevalence of diabetes is increasing globally. More than 690 million cases of diabetes are expected worldwide by 2045. Continuous blood glucose monitoring is essential to control the disease and avoid long-term complications. Diabetics suffer on a daily basis with the traditional glucose monitors currently in use, which are invasive, painful, and cost-intensive. Therefore, the demand for non-invasive, painless, economical, and reliable approaches to monitor glucose levels is increasing. Since the last decades, many glucose sensing technologies have been developed. Researchers and scientists have been working on the enhancement of these technologies to achieve better results. This paper provides an updated review of some of the pioneering non-invasive optical techniques for monitoring blood glucose levels that have been proposed in the last six years, including a summary of state-of-the-art error analysis and validation techniques.

Variable structure robust controller design for blood glucose regulation for type 1 diabetic patients: A backstepping approach

Diabetes mellitus type 1 occurs when β - cells in the pancreas are destroyed by the immune system. As a result, the pancreas cannot produce adequate insulin, and the glucose enters the cells to produce energy. To elevate the glycaemic concentration, sufficient amount of insulin should be taken orally or injected into the human body. Artificial pancreas is a device that automatically regulates the level of body insulin by injecting the requisite amount of insulin into the human body. A finite-time robust feedback controller based on the Extended Bergman Minimal Model is designed here. The controller is designed utilizing the backstepping approach and is robust against the unknown external disturbance and parametric uncertainties. The stability of the system is proved using the Lyapunov theorem. The controller is exponentially stable and hence provides the finite-time convergence of the blood glucose concentration to its desired magnitude. The effectiveness of the proposed control method is shown through simulation in MATLAB/Simulink environment via comparisons with previous studies.

Glucose Level Sensing Using Single Asymmetric Split Ring Resonator

In this article, a biosensor composed of a single metamaterial asymmetric resonator is specifically designed for sensing the glucose level of 1 µL of solution. The resonator has two gaps, and one of them ends with a semicircle shape on which the glucose solution is placed. This design helps in confining the drops of glucose solutions in a specific area where the field is maximally confined in order to enhance the electromagnetic wave-matter interaction. Six samples of glucose solutions with concentrations that cover hypoglycemia, normal and hyperglycemia conditions that vary from around 41 to 312 mg/dL were prepared and examined by this biosensor. The resonance frequency redshift was used as a measure of the changes in the glucose level of the solutions. Without glucose solution, an excellent agreement between the measured and simulated transmission amplitude was observed. The increase in glucose concentrations exhibited clear and noticeable redshifts in the resonance frequency. This biosensor revealed a 0.9997 coefficient of determination, which implies an excellent prediction fitting model. More importantly, a sensitivity of 438 kHz/(mg/dL) was observed over the range of concentrations of the aqueous solution.

Arbitrary-order sliding mode-based robust control algorithm for the developing artificial pancreas mechanism

In Diabetes Mellitus, the pancreas remains incapable of insulin administration that leads to hyperglycaemia, an escalated glycaemic concentration, which may stimulate many complications. To circumvent this situation, a closed-loop control strategy is much needed for the exogenous insulin infusion in diabetic patients. This closed-loop structure is often termed as an artificial pancreas that is generally established by the employment of different feedback control strategies. In this work, the authors have proposed an arbitrary-order sliding mode control approach for development of the said mechanism. The term, arbitrary, is exercised in the sense of its applicability to any n-order controllable canonical system. The proposed control algorithm affirms the finite-time effective stabilisation of the glucose-insulin regulatory system, at the desired level, with the alleviation of sharp fluctuations. The novelty of this work lies in the sliding manifold that incorporates indirect non-linear terms. In addition, the necessary discontinuous terms are filtered-out once before its employment to the plant, i.e. diabetic patient. The robustness, in the presence of external disturbances, i.e. meal intake is confirmed via rigorous mathematical stability analysis. In addition, the effectiveness of the proposed control strategy is ascertained by comparing the results with the standard literature.

Novel algebraic meal disturbance estimation based adaptive robust control design for blood glucose regulation in type 1 diabetes patients

This study designs a robust closed-loop control algorithm for elevated blood glucose level stabilisation in type 1 diabetic patients. The control algorithm is based on a novel control action resulting from integrating algebraic meal disturbance estimator with back-stepping integral sliding mode control (BISMC) technique. The estimator shows finite time convergence leading to accurate and fast estimation of meal disturbance. Moreover, compensation of the estimated disturbance in controller provides significant reduction in chattering phenomenon, which is inherent drawback of sliding mode control (SMC). The controller is applied to one of the most reliable models of type 1 diabetic patients, named Bergman's minimal model. The effectiveness and superiority of the designed controller is shown by comparing it to classical SMC and super-twisting sliding mode control. The designed controller is subject to three different cases for detailed analysis of the controller's robustness against meal disturbance. The three cases considered are hyperglycaemia, hyperglycaemia combined with meal disturbance and three meal disturbance. The simulation results confirm superior performance of algebraic disturbance estimator based BISMC controller for all the cases mentioned above.

Robust observer based control for plasma glucose regulation in type 1 diabetes patient using attractive ellipsoid method

This paper deals with the design of robust observer based output feedback control law for the stabilisation of an uncertain nonlinear system and subsequently apply the developed method for the regulation of plasma glucose concentration in Type 1 diabetes (T1D) patients. The principal objective behind the proposed design is to deal with the issues of intra‐patient parametric variation and non‐availability of all state variables for measurement. The proposed control technique for the T1D patient model is based on the attractive ellipsoid method (AEM). The observer and controller conditions are obtained in terms of linear matrix inequality (LMI), thus allowing to compute easily both the observer and controller gains. The closed‐loop response obtained using the designed controller avoids adverse situations of hypoglycemia and post‐prandial hyperglycemia under uncertain conditions. Further to validate the robustness of the design, closed‐loop simulations of random 200 virtual T1D patients considering parameters within the considered ranges are presented. The results indicate that hypoglycemia and post‐prandial hyperglycemia are significantly reduced in the presence of bounded (±30% ) parametric variability and uncertain exogenous meal disturbance.

Artificial Intelligence for Diabetes Management and Decision Support: Literature Review

Background

Artificial intelligence methods in combination with the latest technologies, including medical devices, mobile computing, and sensor technologies, have the potential to enable the creation and delivery of better management services to deal with chronic diseases. One of the most lethal and prevalent chronic diseases is diabetes mellitus, which is characterized by dysfunction of glucose homeostasis.

Objective

The objective of this paper is to review recent efforts to use artificial intelligence techniques to assist in the management of diabetes, along with the associated challenges.

Methods

A review of the literature was conducted using PubMed and related bibliographic resources. Analyses of the literature from 2010 to 2018 yielded 1849 pertinent articles, of which we selected 141 for detailed review.

Results

We propose a functional taxonomy for diabetes management and artificial intelligence. Additionally, a detailed analysis of each subject category was performed using related key outcomes. This approach revealed that the experiments and studies reviewed yielded encouraging results.

Conclusions

We obtained evidence of an acceleration of research activity aimed at developing artificial intelligence-powered tools for prediction and prevention of complications associated with diabetes. Our results indicate that artificial intelligence methods are being progressively established as suitable for use in clinical daily practice, as well as for the self-management of diabetes. Consequently, these methods provide powerful tools for improving patients’ quality of life.