The contribution of glucagon in an Artificial Pancreas for people with type 1 diabetes

Vladimír  Bátora; Marián  Tárník; Ján  Murgas; Signe Schmidt; Kirsten Nørgaard; Niels Kjølstad Poulsen; Henrik Madsen; Dimitri Boiroux; John Bagterp Jørgensen

doi:10.1109/ACC.2015.7172134

The contribution of glucagon in an Artificial Pancreas for people with type 1 diabetes

Vladimír Bátora, Marián Tárník, Ján Murgas, Signe Schmidt, Kirsten Nørgaard, Niels Kjølstad Poulsen, Henrik Madsen, Dimitri Boiroux, John Bagterp Jørgensen

Research output: Chapter in Book/Report/Conference proceeding › Article in proceedings › Research › peer-review

Abstract

The risk of hypoglycemia is one of the main concerns in treatment of type 1 diabetes (T1D). In this paper we present a head-to-head comparison of a currently used insulin-only controller and a prospective bihormonal controller for blood glucose in people with T1D. The bihormonal strategy uses insulin to treat hyperglycemia as well as glucagon to ensure fast recovery from hypoglycemic episodes. Two separate model predictive controllers (MPC) based on patient-specific models handle insulin and glucagon infusion. In addition, the control algorithm consists of a Kalman filter and a meal time insulin bolus calculator. The feedback is obtained from a continuous glucose monitor (CGM). We implement a bihormonal simulation model with time-varying parameters available for 3 subjects to compare the strategies. We consider a protocol with 3 events - a correct mealtime insulin bolus, a missed bolus and a bolus overestimated by 60%. During normal operation both strategies provide similar results. The contribution of glucagon becomes evident after administration of the overestimated insulin bolus. In a 10h period following an overbolused meal, the bihormonal strategy reduces time spent in hypoglycemia in the most severe case by almost 15% (1.5h), outperforming the insulin-only control. Therefore, glucagon contributes to the safety of an Artificial Pancreas.

Original language	English
Title of host publication	Proceedings of the 2015 American Control Conference (ACC)
Publisher	IEEE
Publication date	2015
Pages	5097-5102
ISBN (Print)	978-1-4799-8685-9
DOIs	https://doi.org/10.1109/ACC.2015.7172134
Publication status	Published - 2015
Event	2015 American Control Conference - Chicago, United States Duration: 1 Jul 2015 → 3 Jul 2015

Conference

Conference	2015 American Control Conference
Country/Territory	United States
City	Chicago
Period	01/07/2015 → 03/07/2015

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "The contribution of glucagon in an Artificial Pancreas for people with type 1 diabetes",

abstract = "The risk of hypoglycemia is one of the main concerns in treatment of type 1 diabetes (T1D). In this paper we present a head-to-head comparison of a currently used insulin-only controller and a prospective bihormonal controller for blood glucose in people with T1D. The bihormonal strategy uses insulin to treat hyperglycemia as well as glucagon to ensure fast recovery from hypoglycemic episodes. Two separate model predictive controllers (MPC) based on patient-specific models handle insulin and glucagon infusion. In addition, the control algorithm consists of a Kalman filter and a meal time insulin bolus calculator. The feedback is obtained from a continuous glucose monitor (CGM). We implement a bihormonal simulation model with time-varying parameters available for 3 subjects to compare the strategies. We consider a protocol with 3 events - a correct mealtime insulin bolus, a missed bolus and a bolus overestimated by 60%. During normal operation both strategies provide similar results. The contribution of glucagon becomes evident after administration of the overestimated insulin bolus. In a 10h period following an overbolused meal, the bihormonal strategy reduces time spent in hypoglycemia in the most severe case by almost 15% (1.5h), outperforming the insulin-only control. Therefore, glucagon contributes to the safety of an Artificial Pancreas.",

author = "Vladim{\'i}r B{\'a}tora and Mari{\'a}n T{\'a}rn{\'i}k and J{\'a}n Murgas and Signe Schmidt and Kirsten N{\o}rgaard and Poulsen, {Niels Kj{\o}lstad} and Henrik Madsen and Dimitri Boiroux and J{\o}rgensen, {John Bagterp}",

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Bátora, V, Tárník, M, Murgas, J, Schmidt, S, Nørgaard, K, Poulsen, NK , Madsen, H, Boiroux, D & Jørgensen, JB 2015, The contribution of glucagon in an Artificial Pancreas for people with type 1 diabetes. in Proceedings of the 2015 American Control Conference (ACC). IEEE, pp. 5097-5102, 2015 American Control Conference, Chicago, Illinois, United States, 01/07/2015. https://doi.org/10.1109/ACC.2015.7172134

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AU - Bátora, Vladimír

AU - Tárník, Marián

AU - Murgas, Ján

AU - Schmidt, Signe

AU - Nørgaard, Kirsten

AU - Poulsen, Niels Kjølstad

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AU - Boiroux, Dimitri

AU - Jørgensen, John Bagterp

PY - 2015

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N2 - The risk of hypoglycemia is one of the main concerns in treatment of type 1 diabetes (T1D). In this paper we present a head-to-head comparison of a currently used insulin-only controller and a prospective bihormonal controller for blood glucose in people with T1D. The bihormonal strategy uses insulin to treat hyperglycemia as well as glucagon to ensure fast recovery from hypoglycemic episodes. Two separate model predictive controllers (MPC) based on patient-specific models handle insulin and glucagon infusion. In addition, the control algorithm consists of a Kalman filter and a meal time insulin bolus calculator. The feedback is obtained from a continuous glucose monitor (CGM). We implement a bihormonal simulation model with time-varying parameters available for 3 subjects to compare the strategies. We consider a protocol with 3 events - a correct mealtime insulin bolus, a missed bolus and a bolus overestimated by 60%. During normal operation both strategies provide similar results. The contribution of glucagon becomes evident after administration of the overestimated insulin bolus. In a 10h period following an overbolused meal, the bihormonal strategy reduces time spent in hypoglycemia in the most severe case by almost 15% (1.5h), outperforming the insulin-only control. Therefore, glucagon contributes to the safety of an Artificial Pancreas.

AB - The risk of hypoglycemia is one of the main concerns in treatment of type 1 diabetes (T1D). In this paper we present a head-to-head comparison of a currently used insulin-only controller and a prospective bihormonal controller for blood glucose in people with T1D. The bihormonal strategy uses insulin to treat hyperglycemia as well as glucagon to ensure fast recovery from hypoglycemic episodes. Two separate model predictive controllers (MPC) based on patient-specific models handle insulin and glucagon infusion. In addition, the control algorithm consists of a Kalman filter and a meal time insulin bolus calculator. The feedback is obtained from a continuous glucose monitor (CGM). We implement a bihormonal simulation model with time-varying parameters available for 3 subjects to compare the strategies. We consider a protocol with 3 events - a correct mealtime insulin bolus, a missed bolus and a bolus overestimated by 60%. During normal operation both strategies provide similar results. The contribution of glucagon becomes evident after administration of the overestimated insulin bolus. In a 10h period following an overbolused meal, the bihormonal strategy reduces time spent in hypoglycemia in the most severe case by almost 15% (1.5h), outperforming the insulin-only control. Therefore, glucagon contributes to the safety of an Artificial Pancreas.

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M3 - Article in proceedings

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SP - 5097

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BT - Proceedings of the 2015 American Control Conference (ACC)

PB - IEEE

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Y2 - 1 July 2015 through 3 July 2015

ER -

The contribution of glucagon in an Artificial Pancreas for people with type 1 diabetes

Abstract

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UN SDGs

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