The artificial pancreas (AP) system or closed-loop blood glucose (BG) regulation is a technological advancement that aims to relieve diabetic subjects from their current decision-making burden while tightening their BG levels. However, large disturbances such as meals and exercise still pose great challenges to a fully closed-loop system. In this paper, the problem of BG regulation with unannounced physical activity for type 1 diabetic subjects is addressed. We use a coordinated control strategy with insulin infusion and extra carbohydrates (CHO) for hypoglycemia avoidance. The insulin algorithm is based on a proportional–derivative controller with insulin feedback and the so-called safety auxiliary feedback element (SAFE) layer, and the algorithm for CHO is based on a predictive, quantified proportional-derivative controller. The UVa/Padua simulator glucose-insulin model is modified to include the effects of physical activity and is used to test the new AP. We consider scenarios where the subject does not announce physical activity and with challenging meals. Then, we analyze the performance and robustness of the combined insulin and CHO recommender system and compare them to the insulin-only controller. The simulation results show that the new AP system is able to mitigate daily hypoglycemia episodes (0.9 versus 0.2, $p < 0.01$ ) and increase the time in range during day (91.5% versus 92.4%, $p < 0.01$ ) without increasing the time above 180 mg/dl (6.3% versus 6.4%, $p > 0.05$ ).

中文翻译：

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一种针对1型糖尿病患者的暗中进行运动的新血糖控制方案

人造胰腺（AP）系统或闭环血糖（BG）调节是一项技术进步，旨在减轻糖尿病患者目前的决策负担，同时提高其BG水平。但是，诸如吃饭和运动之类的大麻烦仍然给完全闭环系统带来巨大挑战。在本文中，解决了针对1型糖尿病受试者的未经宣布的身体活动而进行BG调节的问题。我们使用胰岛素输注和额外碳水化合物（CHO）的协调控制策略来避免低血糖症。胰岛素算法基于具有胰岛素反馈和所谓的安全辅助反馈元素（SAFE）层的比例-微分控制器，而CHO算法则基于可预测的量化比例-微分控制器。修改了UVa / Padua仿真器葡萄糖-胰岛素模型，以包括体力活动的影响，并用于测试新的AP。我们考虑了这样的场景：受试者没有宣布进行体育锻炼，并且进餐困难。然后，我们分析了组合的胰岛素和CHO推荐系统的性能和耐用性，并将它们与仅使用胰岛素的控制器进行比较。仿真结果表明，新的AP系统能够缓解每日发生的低血糖事件（分别为0.9和0.2，我们分析了组合的胰岛素和CHO推荐系统的性能和耐用性，并将其与仅使用胰岛素的控制器进行比较。仿真结果表明，新的AP系统能够缓解每日发生的低血糖事件（分别为0.9和0.2，我们分析了组合的胰岛素和CHO推荐系统的性能和耐用性，并将其与仅使用胰岛素的控制器进行比较。仿真结果表明，新的AP系统能够缓解每日发生的低血糖事件（分别为0.9和0.2， $ p <0.01 $ ），并增加白天范围内的时间（91.5％对92.4％， $ p <0.01 $ ），而不会增加时间到180 mg / dl以上（6.3％对6.4％， $ p> 0.05 $ ）。