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Control of Blood Glucose Level for Type 1 Diabetes Mellitus using Improved Hovorka Equations: Comparison between Clinical and In-Silico Works
bioRxiv - Bioengineering Pub Date : 2020-10-09 , DOI: 10.1101/2020.10.09.332809
Nur’Amanina Mohd Sohadi , Ayub Md Som , Noor Shafina Mohd Nor , Nur Farhana Mohd Yusof , Sherif Abdulbari Ali , Noor Dyanna Andres Pacana

Background: Type 1 diabetes mellitus (T1DM) occurs due to inability of the body to produce sufficient amount of insulin to regulate blood glucose level (BGL) at normoglycemic range between 4.0 to 7.0 mmol/L. Thus, T1DM patients require to do self-monitoring blood glucose (SMBG) via finger pricks and depend on exogenous insulin injection to maintain their BGL which is very painful and exasperating. Ongoing works on artificial pancreas device nowadays focus primarily on a computer algorithm which is programmed into the controller device. This study aims to simulate so-called improved equations from the Hovorka model using actual patients’ data through in-silico works and compare its findings with the clinical works. Methods: The study mainly focuses on computer simulation in MATLAB using improved Hovorka equations in order to control the BGL in T1DM. The improved equations can be found in three subsystems namely; glucose, insulin and insulin action subsystems. CHO intakes were varied during breakfast, lunch and dinner times for three consecutive days. Simulated data are compared with the actual patients’ data from the clinical works. Results: Result revealed that when the patient took 36.0g CHO during breakfast and lunch, the insulin administered was 0.1U/min in order to maintain the blood glucose level (BGL) in the safe range after meal; while during dinner time, 0.083U/min to 0.1 U/min of insulins were administered in order to regulate 45.0g CHO taken during meal. The basal insulin was also injected at 0.066U/min upon waking up time in the early morning. The BGL was able to remain at normal range after each meal during in-silico works compared to clinical works. Conclusions: This study proved that the improved Hovorka equations via in-silico works can be employed to model the effect of meal disruptions on T1DM patients, as it demonstrated better control as compared to the clinical works.

中文翻译:

使用改进的Hovorka方程控制1型糖尿病的血糖水平:临床研究与人工研究之间的比较

背景:1型糖尿病(T1DM)的发生是由于人体无法产生足够的胰岛素来将血糖水平(BGL)调节在4.0至7.0 mmol / L的正常血糖范围内。因此,T1DM患者需要通过手指刺刺进行自我监测血糖(SMBG),并依靠外源性胰岛素注射来维持其BGL,这非常痛苦且令人生厌。如今,在人工胰腺设备上正在进行的工作主要集中在编程到控制器设备中的计算机算法上。这项研究的目的是通过计算机模拟工作使用实际患者的数据模拟Hovorka模型中的所谓改进方程,并将其发现与临床工作进行比较。方法:本研究主要针对使用改进的Hovorka方程在MATLAB中进行计算机仿真,以控制T1DM中的BGL。改进的方程可以在三个子系统中找到:葡萄糖,胰岛素和胰岛素作用子系统。连续三天的早餐,午餐和晚餐时间,CHO的摄入量有所不同。将模拟数据与临床工作中实际患者的数据进行比较。结果:结果显示,当患者在早餐和午餐时服用36.0g CHO时,为了维持餐后血糖水平(BGL),胰岛素的剂量为0.1U / min。晚餐时,以0.083U / min至0.1 U / min的剂量给予胰岛素,以调节餐时服用的45.0g CHO。在清晨起床时,也以0.066U / min的速度注射基础胰岛素。与临床工作相比,BGL能够在每次进餐后在计算机内工作期间保持在正常范围内。结论:
更新日期:2020-10-11
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