title: An Actor-Critic based controller for glucose regulation in type 1 diabetes.
abstract: A novel adaptive approach for glucose control in individuals with type 1 diabetes under sensor-augmented pump therapy is proposed. The controller, is based on Actor-Critic (AC) learning and is inspired by the principles of reinforcement learning and optimal control theory. The main characteristics of the proposed controller are (i) simultaneous adjustment of both the insulin basal rate and the bolus dose, (ii) initialization based on clinical procedures, and (iii) real-time personalization. The effectiveness of the proposed algorithm in terms of glycemic control has been investigated in silico in adults, adolescents and children under open-loop and closed-loop approaches, using announced meals with uncertainties in the order of ±25% in the estimation of carbohydrates. The results show that glucose regulation is efficient in all three groups of patients, even with uncertainties in the level of carbohydrates in the meal. The percentages in the A+B zones of the Control Variability Grid Analysis (CVGA) were 100% for adults, and 93% for both adolescents and children. The AC based controller seems to be a promising approach for the automatic adjustment of insulin infusion in order to improve glycemic control. After optimization of the algorithm, the controller will be tested in a clinical trial.
authors.affiliation: ARTORG Center for Biomedical Engineering Research, Diabetes Technology Research Group, University of Bern, Murtenstrasse 50, 3010 Bern, Switzerland.
authors.forename: Elena
authors.initials: E
authors.lastname: Daskalaki
authors.forename: Peter
authors.initials: P
authors.lastname: Diem
authors.forename: Stavroula G
authors.initials: SG
authors.lastname: Mougiakakou
mesh_terms: D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D013557:Switzerland
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin