FEEDBACK CONTROL OF TYPE 1 DIABETES

Sandip D. Kulkarni

By Sandip Kulkarni 1
 Type 1 Diabetes Mellitus
Hyperglycemia: Kidney failure, heart
disease, blindness, brain damage
180 mg/dl

Target
Blood
Glucose (BG)
range

Overcom-
70 mg/dl pensation
Hypoglycemia: Neurological
60 mg/dl damage, unconsciousness,
seizures, death Severe
Hypoglycemia
By Sandip Kulkarni 2
 Glucose Sensing
Self Monitoring of Blood Continuous Glucose
Glucose (SMBG) Monitoring (CGM) Device

Pricks into
the
abdominal
Finger prick Noisy signals skin
Provides estimates of blood Delay
glucose (BG) only when the Sensor faults (drift, dropout)
user samples Requires calibration with SMBG
Sensor performance variability
Requires a control solution
(+/- 30% or more observed**)
Inaccurate measurement (+/- FDA-approved only for use with
20% observed*) SMBG
By Sandip Kulkarni 3
 Insulin Delivery Mechanisms
Continuous Subcutaneous Insulin Infusion (CSII)
User entry:

Insulin Basal Rate Insulin Delivery

Profile (Actuation)
Insulin Bolus
SMBG
Meal Size (gCHO)

OPEN LOOP THERAPY

Multiple Daily Insulin Injection (MDI)

Bolus dose
to cover food eaten or
correct a high BG
Basal dose
By Sandip Kulkarni 4
 Modeling Simulation and Control for
Diabetes Management
System Model of Human
Metabolism
Physiologically
acceptable,
Based on years of
study and represent
most of the studied
population
Modularizing
subcomponent models
to easily plug improved
models in future .
Embedding into a
Simulator System.
Developing and Testing
Control Algorithms
Integration. Artificial Pancreas System
By Sandip Kulkarni (UVA + UCSB 5+Univ. of Padova)
Components of the Entire System

By Sandip Kulkarni 6
 Linearized discrete-time model
u(k)
insulin infusion GLUCOSE
x(k+1)=Ax(k)+Bu(k) y(k)=Cx(k)
+Gc(k) +v(k)
SENSOR
d(k)
meal

States
G glucose
X Insulin sensitivity

I sc1
Insulin in Intradermal
I
sc 2 Compartments
x
I p Insulin in Plasma

Gsc Infused Glucose
Q
1
Stomach Compartments C=(100000
Q2 By Sandip Kulkarni
00) 7
 What happens today...

Meals,
Exercise
INSULIN
PUMP
bolus
basal
Open-loop
Subject
therapy

GLUCOSE
SENSOR

By Sandip Kulkarni 8
 Control Block Diagram

Open-loop bolus Meals,

therapy basal Exercise
INSULIN
PUMP

MPC
bolus
basal + Safety
Mod.
Subject

GLUCOSE
SENSOR

By Sandip Kulkarni 9
 18 Hour Closed Loop Control Experiment in
Hospital
4 PM: 30 min 7 PM: manual 4.4u pre-meal Overnight
220 2.2

Insulin injection concentration [mg/dl]

low- bolus meal underinsulinized maintenance of basal
intensity by 40% rate
200 2
Glucose concentration [mg/dl]

exercise

180 1.8

160 1.6

140 1.4

120 Range 1.2

correction
compensat
100 1
es under-
bolused
80 meal 0.8
Safety
System
60 reduces 0.6
insulin to
40 prevent 0.4
hypoglyce
20 mia 0.2

12:00 14:00 16:00 18:00 20:00 22:00 00:00 02:00 04:00 06:00 08:00
Finger Sticks CGM Insulin injection

By Sandip Kulkarni 10