First use of model predictive control in outpatient wearable artificial pancreas.
OBJECTIVE
Inpatient studies suggest that model predictive control (MPC) is one of the most promising algorithms for artificial pancreas (AP). So far, outpatient trials have used hypo/hyperglycemia-mitigation or medical-expert systems. In this study, we report the first wearable AP outpatient study based on MPC and investigate specifically its ability to control postprandial glucose, one of the major challenges in glucose control.


METHODS
A new modular MPC algorithm has been designed focusing on meal control. Six type 1 diabetes mellitus patients underwent 42-h experiments: sensor-augmented pump therapy in the first 14 h (open-loop) and closed-loop in the remaining 28 h.


RESULTS
MPC showed satisfactory dinner control versus open-loop: time-in-target (70-180 mg/dL) 94.83 vs. 68.2% and time-in-hypo 1.25 vs. 11.9%. Overnight control was also satisfactory: time-in-target 89.4 vs. 85.0% and time-in-hypo: 0.00 vs. 8.19%.


CONCLUSIONS
This outpatient study confirms inpatient evidence of suitability of MPC-based strategies for AP. These encouraging results pave the way to randomized crossover outpatient studies.
Corresponding author: Claudio Cobelli, cobelli@dei.unipd.it.
Simone
S
Del Favero
Daniela
D
Bruttomesso
Federico
F
Di Palma
Giordano
G
Lanzola
Roberto
R
Visentin
Alessio
A
Filippi
Rachele
R
Scotton
Chiara
C
Toffanin
Mirko
M
Messori
Stefania
S
Scarpellini
Patrick
P
Keith-Hynes
Boris P
BP
Kovatchev
J Hans
JH
Devries
Eric
E
Renard
Lalo
L
Magni
Angelo
A
Avogaro
Claudio
C
Cobelli
D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000628:therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007003:Hypoglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D019397:Pancreas, Artificial; D019518:Postprandial Period; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin