title: The INCA system: a further step towards a telemedical artificial pancreas.
abstract: Biomedical engineering research efforts have accomplished another level of a "technological solution" for diabetes: an artificial pancreas to be used by patients and supervised by healthcare professionals at any time and place. Reliability of continuous glucose monitoring, availability of real-time programmable insulin pumps, and validation of safe and efficient control algorithms are critical components for achieving that goal. Nevertheless, the development and integration of these new technologies within a telemedicine system can be the basis of a future artificial pancreas. This paper introduces the concept, design, and evaluation of the "intelligent control assistant for diabetes, INCA" system. INCA is a personal digital assistant (PDA)-based personal smart assistant to provide patients with closed-loop control strategies (personal and remote loop), based on a real-time continuous glucose sensor (Guardian RT, Medtronic), an insulin pump (D-TRON, Disetronic Medical Systems), and a mobile general packet radio service (GPRS)-based telemedicine communication system. Patient therapeutic decision making is supervised by doctors through a multiaccess telemedicine central server that provides to diabetics and doctors a Web-based access to continuous glucose monitoring and insulin infusion data. The INCA system has been technically and clinically evaluated in two randomized and crossover clinical trials showing an improvement on glycaemic control of diabetic patients.
authors.affiliation: Universidad Politécnica de Madrid, 28040-Madrid, Spain. egomez@gbt.tfo.upm.es
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Gómez
authors.forename: M Elena
authors.initials: ME
authors.lastname: Hernando Pérez
authors.forename: Thomas
authors.initials: T
authors.lastname: Vering
authors.forename: Mercedes
authors.initials: M
authors.lastname: Rigla Cros
authors.forename: Oliver
authors.initials: O
authors.lastname: Bott
authors.forename: Gema
authors.initials: G
authors.lastname: García-Sáez
authors.forename: Peter
authors.initials: P
authors.lastname: Pretschner
authors.forename: Eulalia
authors.initials: E
authors.lastname: Brugués
authors.forename: Oliver
authors.initials: O
authors.lastname: Schnell
authors.forename: Caroline
authors.initials: C
authors.lastname: Patte
authors.forename: Joachim
authors.initials: J
authors.lastname: Bergmann
authors.forename: Ralf
authors.initials: R
authors.lastname: Dudde
authors.forename: Alberto
authors.initials: A
authors.lastname: de Leiva
mesh_terms: D021522:Bioartificial Organs; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D003199:Computer Systems; D034201:Computers, Handheld; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D007332:Insulin Infusion Systems; D010179:Pancreas; D012646:Self Administration / Q000295:instrumentation* / Q000379:methods; D017216:Telemedicine / Q000295:instrumentation*; D013813:Therapy, Computer-Assisted / Q000295:instrumentation* / Q000379:methods