Insulin stacking is one of the major concerns in intensive insulin therapy for type 1 diabetes. Despite the development of several control strategies for constraining the insulin-on-board (IOB), the benefits and drawbacks of this type of constraint under hypo- and hyperglycemia sensitivity scenarios have not been deeply analyzed for model-based controllers. Here, a safety layer based on IOB estimation is coupled with an impulsive offset-free zone model predictive control to tackle this problem. First, the resulting glycemic behavior of applying the safety layer under different scenarios of physiological variations are discussed. And then, simple rules for adapting the safety layer are developed. The envisioned strategy takes advantage of the plant-model mismatch estimation to determine when physiological variations in a subject are inducing hypoglycemia or hyperglycemia, and thus, the IOB safety layer can be tightened or released according to the sign of the estimated mismatch. The performance of the strategy was assessed in-silico on a cohort of 10 adult patients under challenging scenarios considering parameter variations of ±30%, a circadian insulin sensitivity, and sensor noise.

中文翻译：

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针对IOB限制的基于安全层耦合的脉冲MPC的血糖控制策略

胰岛素堆积是1型糖尿病强化胰岛素治疗的主要问题之一。尽管已经开发了几种限制车载胰岛素（IOB）的控制策略，但对于基于模型的控制器，在低血糖和高血糖敏感性情况下这种约束的优缺点仍未得到深入分析。在这里，基于IOB估计的安全层与脉冲无偏移区模型预测控制相结合来解决此问题。首先，讨论了在生理变化的不同情况下应用安全层的最终血糖行为。然后，开发了适用于安全层的简单规则。所设想的策略利用植物模型失配估计来确定受试者的生理变化何时诱发低血糖或高血糖，因此，可以根据所估计的失配的迹象来收紧或释放IOB安全层。在具有挑战性的情况下，考虑参数变化±30％，昼夜节律性胰岛素敏感性和传感器噪声，对10名成年患者进行了计算机模拟评估了该策略的效果。