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Robust μ-synthesis: Towards a unified glucose control in adults, adolescents and children with T1DM
Journal of the Franklin Institute ( IF 3.7 ) Pub Date : 2020-07-29 , DOI: 10.1016/j.jfranklin.2020.07.030
Eduardo Ruiz-Velázquez , Julio García-Rodríguez , Griselda Quiroz , Ricardo Femat

Type 1 Diabetes Mellitus (T1DM) remains as a severe public health problem in a wide range of population, from children to adults. Recently, the number of diabetics worldwide and morbility rates are increasing. Therefore, emerging technologies as the artificial pancreas (AP) are directing their efforts to improve treatments and to reduce long-term complications. In this work, a cross-age control strategy is proposed to tackle the blood glucose regulation problem in people with T1DM. The contribution of this paper is focused on the blood glucose regulation in T1DM patients, at distinct ages, and it can be controlled in face to physiological uncertain parameters. In other words, a robust model-based controller is proposed via μ-synthesis technique by considering structured uncertainties in physiological meaningful parameters. The proposed controller exhibits the feasibility for blood glucose regulation in virtual diabetic children, adolescents and adults. The relevance of these parameters lies in their high sensitivity to the solutions of a physiological mathematical model; that is, a slight parametric variation can lead to a hyperglycemic scenario. Thus, it is innovative to consider this uncertainties scheme in parameters that are directly related to the glucose dynamics. The robust control algorithm was integrated into the well-known Uva/Padova simulator for T1DM to show the technical viability of this methodology in the available three populations. The outcomes of a control variability grid analysis show that 90.9% of virtual adults are in upper B-zone and 9.09% in B-zone. Likewise for virtual adolescents, 90.9% fall in upper B-zone and 9.09% B-zone. Regarding children, 63.63% lie in upper B-zone, 27.27% B-zone and only 9.09% failure to deal with hypoglycemia. Furthermore, the results are compared to the ones obtained from H schemes previously reported which also were implemented in the simulator. Despite being a theoretical approach, the results reveal that the proposed cross-age control scheme could be a useful strategy in the development of real PA systems that lead to future clinical trials in humans.



中文翻译:

强大的μ合成:在患有T1DM的成人,青少年和儿童中实现统一的葡萄糖控制

1型糖尿病(T1DM)仍然是从儿童到成人的广泛人群中的严重公共卫生问题。最近,全世界的糖尿病患者数量和发病率正在增加。因此,作为人工胰腺(AP)的新兴技术正在指导其努力,以改善治疗方法并减少长期并发症。在这项工作中,提出了一种跨年龄控制策略来解决T1DM患者的血糖调节问题。本文的贡献集中于不同年龄的T1DM患者的血糖调节,并且可以面对生理不确定性参数进行控制。换句话说,通过μ提出了一种基于模型的鲁棒控制器。生理意义参数中考虑结构不确定性的合成技术。拟议中的控制器展示了在虚拟糖尿病儿童,青少年和成人中进行血糖调节的可行性。这些参数的相关性在于它们对生理数学模型解的高度敏感性。也就是说,轻微的参数变化会导致血糖过高。因此,在与葡萄糖动力学直接相关的参数中考虑该不确定性方案是创新的。鲁棒的控制算法已集成到著名的T1DM Uva / Padova仿真器中,以显示此方法在可用的三个人群中的技术可行性。控制变异性网格分析的结果表明,有90.9%的虚拟成年人位于上B区,其中9。B区占09%。同样,虚拟青少年的B区上限下降90.9%,B区下降9.09%。对于儿童,有63.63%的人位于上B区,27.27%的B区,只有9.09%的人无法应对低血糖症。此外,将结果与从H先前报告的方案也已在模拟器中实现。尽管是一种理论方法,但结果表明,提出的跨年龄控制方案可能是开发可用于人类未来临床试验的真实PA系统的有用策略。

更新日期:2020-09-10
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