Development of

Microprocessor or PC-based
External Artificial Pancreas
- A Case Study

Soegijardjo Soegijoko
Biomedical Engineering Program
School of Electrical Engineering & Informatics
Institut Teknologi Bandung
 OUTLINE
 INTRODUCTION
 DIABETES MELLITUS
 FUNCTIONAL DESCRIPTION
 SYSTEM DESCRIPTION
 EXPERIMENTAL RESULTS
 CONCLUSIONS
 FINAL REMARKS

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 1. INTRODUCTION
 Pancreas = a dual purpose organ that
function as a digestive gland and also to
control the metabolic process in the
body.
 The Pancreas consists of:
– The accini that produce the pancreatic juice
into the duodenum
– The islets of Langerhans (consist mainly of
beta cells) produce at least 4 types of
hormones

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 Introduction
 The islets of Langerhans consist mainly of:
– Beta cells that secrete insulin
– Alpha cells which produce glucagon
 Insulin promotes the uptake of glucose from
the blood by the body cells: by facilitating the
passage of glucose through the outer
membrane of the cells. In the absence of
insulin, less glucose is consumed as fuel and
not adequately stored, so that more and more
glucose accumulates until it spills over into the
urine.

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 Introduction
 Diabetes: The two kinds of disease having a
common symptom, i.e. abnormal excess of
urine.
– Diabetes Insipidus: uncommon disorder, in which a
large volume of urine is formed regardless of the
body’s store of water. It is a breakdown of the
regulation of keeping a constant blood dilution, that
include the kidneys’ function. Possible cause:
» Failure of pituitary gland to secrete anti-diuretic hormone
(ADH)
» Hypothalamus fails to govern the secretion of ADH in
response to changes in blood dilution
– Diabetes Mellitus: --see next section--

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 2. DIABETES MELLITUS
 Concise information on Diabetes
Mellitus: a prevalent disease that
characterized by a relative or absolute
insulin deficiency. The earliest symptom
is the lost of control of the circulating
blood glucose level.
 Possible therapies:

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 DIABETES MELLITUS
 Possible therapies for DM:
– Diet & exercise
– Oral anti-diabetics
– Conventional Insulin therapy
– Conventional Insulin therapy can be
improved by:
» Non-Implanted Prosthesis
» Implanted prosthesis: implanted artificial beta
cell, hybrid artificial pancreas
» Transplantation: donor problems, complication
risks

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 DIABETES MELLITUS
 Non-implanted prosthesis (artificial
organ, two principles:
– An open-loop artificial pancreas
– A closed-loop artificial pancreas:
» Insulin & dextrose are infused simultaneously
(e.g. Biostator of Miles corp.)
» Insulin only is used (e.g. Prof. Mirouze’s method)

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 (a)

(b)

Blood
2 cm

Simplified Diagram of a Hybrid

Artificial Pancreas: it consists of: (a).
Fiber “tubes” and (b) the Beta Cells
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 Skin

(e)
(a)

(c) (d)
(b)
Simplified schema of an implantable
artificial pancreas, consisting of: (a)
transducer, (b) battery, (c) control unit,
(d) insulin pump, (e) insulin reservoir.

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 Open loop AP (external or implanted)

Microprocessor/micro-
controller-based
Insulin Pump
Insulin
injection
The insulin pump can be programmed to deliver a
certain amount of insulin injection
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Implantable
Insulin Pump

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 Closed loop AP (external or implanted)
Insulin
Blood
injection
Continuous
Blood Insulin
Glucose Pump
Analyzer
Patient

Control Unit

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3. FUNCTIONAL DESCRIPTION
 EAP = closed loop blood glucose regulation
system consisted of:
– Continuous Blood glucose analyzer
– Microprocessor-based control unit (can be replaced
by microcontroller or PC-based system)
– Insulin pump
 Block diagram
 The method was developed by Prof. Mirouze
(l’Hopital St. Elois, Montpellier, France)
 How it works:

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 FUNCTIONAL DESCRIPTION
 How it works:
– The input signal (blood glucose) is sampled
every 2 seconds
– After processing by the control unit, it
determines the insulin infusion rate
(U/hour) to be delivered to the patient
– Use of an algorithm and certain functions
predetermined or selected by the user
– The system delivers insulin only to achieve
stabilization of the plasma glucose

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 Insulin Glucose Transfer
Insulin Characteristics
required

i1

Positive
slope Negative
slope

i2

g1
Blood glucose level

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 Insulin
required

Insulin –Glucose
Transfer
Characteristics

Blood glucose level

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3. FUNCTIONAL DESCRIPTION
 The Algorithm: a user may choose one of
the 4 different insulin-glucose transfer
characteristics
 Four important functions of the EAP:
– A).Linear & projected mode of operations
– B).Flash insulin: a large bolus (flash) of
insulin infusion in a relatively short period in
response to a rapid rise of glycemia

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 FUNCTIONAL DESCRIPTION
-C).Alarm systems (audible and/or visible
alarms):
» Static Alarm
» Dynamic Alarm
-D).Calibration

Linear mode: g = g(t)

Projected mode: gp = g(t) + slope x t
(according to the selected transfer characteristics)
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 4. SYSTEM DESCRIPTION
 Simplified block diagram
 It may consist of: a microprocessor unit (MPU),
RAM (read write memory), read only memory
(ROM), input-output unit (I/O), timer, analog
to digital converter (ADC), digital to analog
converter (DAC), Control panel
(There are many types of microprocessor or
microcontroller available in the market, having
specific technical specifications that may be
selected)
 Software: simplified flow-chart
 Brief description

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 SYSTEM DESCRIPTION
 (Different types of microprocessor
or microcontroller might be used):
Motorola, Intel, Atmel or other
families
 Specific hardware module & software
module according to the selected
microprocessor/microcontroller
 Software: simplified flow-chart
 Brief description

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 Elements of Simplified Flow Chart
 Start
 Initialization
 Need Calibration? Calibration steps
 Sampling & Computation of mean Glycemia value
 Test Glycemia level, then Static alarm
 Slope computation
 Test for Dynamic alarm, then activate
 Need automatic insulin flash? Then insulin flash
injection
 Mode of operation: Linear or Projected mode
 Required Insulin injection

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 Simplified
start Flowchart
D- Dynamic
Alarm alarm?

Initialization Flash Automatic

Flash?

Calibration? Calibration Select operating

mode

Sampling & glycemia Insulin

computation Injection

Static Static
alarm? alarm

Slope computation
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 Blood Insulin
injection

Blood Insulin
Pump
glucose
analyzer

Waste
Electric Signal

Signal Control Unit

conditioner

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 Microprocessor-based System
(the P system consists of several IC chips)
 P = microprocessor, microprocessor unit

I/O = input P I/O

(MPU)
output unit
RAM=
Random
RAM ROM
Access
Memory
ROM= Read Application
Only software
Memory
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 Microcontroller-based System
(Microcontroller= single chip microprocessor
system)
Input/output
The single chip
has all functions
of
microprocessor, output
I/O,
RAM, ROM,
input
Timer, others
Application
software

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 Personal Computer-based System
(the microcontroller or microprocessor system
can be replaced by a PC)

Input/output

I/O interface
output

input
Specific
Application
software
(inside)
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 Colorimeter

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BME-External Analyzer
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 5. EXPERIMENTAL RESULTS
 A series of measurements & tests in
electronic laboratory
 Clinical experiments at the Clinique des
Maladies Metaboliques, Hopital Saint
Elois: more than 75% remissions of
juvenile diabetes have been obtained
 Further intensive research should be
conducted

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Blood glucose Insulin
Insulin flash (U/h)
level (mg/dl)

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 6. CONCLUSIONS
 A closed-loop external artificial pancreas with
insulin infusion only
 Implementations: microprocessor-based system
microcontroller/PC based system
 Flexible & stable performance have been
obtained
 Excellent clinical results are expected
 Further improvements:
– New & better algorithms
– the use of micro-controller for better performance &
smaller dimension

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 FINAL REMARKS
 Following similar logical steps, different
types of microprocessor/microcontroller/
PC-based Biomedical Instrument (for
diagnostic or therapeutic purposes) can be
developed. E.g.: ECG, EMG, Blood Pressure
monitor, Audiometer, …… etc.
 Different medical background information
will be required
 Synergic collaboration is a must !

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 “External Artificial Pancreas with
Wireless Control”
Blood Glucose Insulin Pump &
Sensor & RF RF Receiver
Transmitter

Radio Radio
Frequency
Frequency
Signal
Signal
PC & Software
Glucose Sensor Modules Insulin Pump
Interface Interface

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Ideas for Future BME System Design
 Future development of EAP
 BME systems inspired by similar
technology

 Microprocessor/Microcontroller/PC-
based Biomedical systems 
Examples ??

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 Thank you very much
For your attention

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