Abstract:
BACKGROUND:Applying real-time learning into an artificial pancreas system could effectively track the unpredictable behavior of glucose-insulin dynamics and adjust insulin treatment accordingly. We describe a novel learning algorithm and its performance when integrated into the MD-Logic Artificial Pancreas (MDLAP) system developed by the Diabetes Technology Center, Schneider Children's Medical Center of Israel, Petah Tikva, Israel. METHODS:The algorithm was designed to establish an initial patient profile using open-loop data (Initial Learning Algorithm component) and then make periodic adjustments during closed-loop operation (Runtime Learning Algorithm component). The MDLAP system, integrated with the learning algorithm, was tested in seven different experiments using the University of Virginia/Padova simulator, comprising adults, adolescents, and children. The experiments included simulations using the open-loop and closed-loop control strategy under nominal and varying insulin sensitivity conditions. The learning algorithm was automatically activated at the end of the open-loop segment and after every day of the closed-loop operation. Metabolic control parameters achieved at selected time points were compared. RESULTS:The percentage of time glucose levels were maintained within 70-180 mg/dL for children and adolescents significantly improved when open-loop was compared with day 6 of closed-loop control (P<0.0001) and remained unaltered for the adult group (P=0.11) during nominal conditions. In varying insulin sensitivity conditions, the percentage of time glucose levels were below 70 mg/dL was significantly reduced by approximately sevenfold (P<0.001). These observations were correlated with significant reduction in the Low Blood Glucose Index (P<0.001). CONCLUSIONS:The new algorithm was effective in characterizing the patient profiles from open-loop data and in adjusting treatment to provide better glycemic control during closed-loop control in both conditions. These findings warrant corroboratory clinical trials.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Miller S,Nimri R,Atlas E,Grunberg EA,Phillip Mdoi
10.1089/dia.2010.0216subject
Has Abstractpub_date
2011-10-01 00:00:00pages
983-90issue
10eissn
1520-9156issn
1557-8593journal_volume
13pub_type
杂志文章abstract:BACKGROUND:Currently, it is still unknown whether differences in glycemic control have any effect on glucose and insulin kinetics after vildagliptin administration. The aim of this study was to evaluate the effect of vildagliptin on glucose and insulin concentrations during a 24-h period in type 2 diabetes patients wit...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2013.0020
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Persistent use of real-time continuous glucose monitoring (CGM) improves diabetes control in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D). METHODS:PRECISE II was a nonrandomized, blinded, prospective, single-arm, multicenter study that evaluated the accuracy and safety of the implantable...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2017.0142
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:This study was designed to assess whether waist circumference can predict metabolic syndrome abnormalities in primary schoolchildren. RESEARCH DESIGN AND METHODS:Of 5,103 children (2,526 males) 4-13 years old who underwent anthropometric measurements, 530 had more extensive testing. Body mass index (BMI), wa...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2006.0017
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Computer decision support systems are potentially effective methods for adjusting insulin, but current models do not take into account simultaneous changes of more than one agent. We describe the development of the Multiagent Intelligent Dosing System (MAIDS, Dimensional Dosing Systems, Wexford, PA) for pred...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2005.7.937
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Adherence to established standards (e.g., International Organization for Standardization [ISO] 15197) is important to ensure comparable and sufficient accuracy of systems for self-monitoring of blood glucose (SMBG). Accuracy evaluation was performed for different SMBG systems available in Europe with three r...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2015.0085
更新日期:2015-09-01 00:00:00
abstract::Diabetic nephropathy is one of the major causes of end-stage renal disease and is often associated with other macrovascular complications such as ischemic heart disease and peripheral vascular disease. Angiotensin converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (AIIR) have both been shown to ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/152091502760098456
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Type 1 diabetic patients have high instability of daily glucose levels. The aim of this study was to evaluate the long-term effects of continuous subcutaneous insulin infusion (CSII) therapy, compared with multiple daily injections of insulin (MDI), on glucose variability, in young type 1 diabetic patients t...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2017.0334
更新日期:2018-02-01 00:00:00
abstract::This study was designed to determine plasma glucose and insulin levels after administration of three escalating doses of the oral insulin product hexyl-insulin monoconjugate 2 (HIM2) in fasting, insulin-deprived adult patients with type 1 diabetes. The study was also designed to assess the safety of the product. Sixte...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091502760306544
更新日期:2002-01-01 00:00:00
abstract:: Background: Continuous glucose monitoring (CGM) is a method of estimating blood glucose values from those recorded in the interstitial fluid. Because increasingly longer CGM measurements are possible, errors and data loss become more and more likely and potentially more da...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2018.0247
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Glucose variability (GV) has been increasingly (or more extensively) studied in patients with type 1 diabetes (T1D) in the ambulatory setting; limited data exist on GV in hospitalized patients with T1D. MATERIALS AND METHODS:Retrospective single center cohort study, we analyzed in-hospital glucose measureme...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2017.0107
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:This article reports a prolonged trial with insulin pumps implanted in patients with type 1 diabetes showing poor glucose control and a high rate of complications. METHODS:We reviewed data from 181 patients undergoing implanted insulin pump therapy. Analysis included hemoglobin A1c (HbA1c) values, body weig...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2010.0209
更新日期:2011-06-01 00:00:00
abstract:: Background: Current manual diabetic retinopathy (DR) screening using eye care experts cannot scale to screen the growing population of diabetes patients who are at risk for vision loss. EyeArt system is an automated, cloud-based artificial intelligence (AI) eye screening t...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2019.0164
更新日期:2019-11-01 00:00:00
abstract:AIMS:This study assessed patient-reported outcomes in a multicenter study of adults with type 2 diabetes taking mealtime Technosphere(®) inhaled insulin (MannKind Corp., Valencia, CA) and basal insulin (insulin glargine) or premixed aspart insulin 70/30. METHODS:Subjects were 618 non-smoking adults with starting hemog...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1089/dia.2011.0037
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:This study was designed to measure pressure and shear reduction of a novel insole design. METHODS:We compared three multilayer viscoelastic insoles to a novel insole design (Glide-Soft, Xilas Medical, Inc., San Antonio, TX). The bottom pad of each insole was fabricated from firm-density Plastazote [Apex Foot...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2005.7.638
更新日期:2005-08-01 00:00:00
abstract::Clustering of diseases has been appreciated by health insurers and epidemiologists for some time. Co-morbidity suggests shared pathways of disease. It is by now well agreed that common diseases have a strong genetic component. Here we present evidence that the angiotensin I-converting enzyme (ACE) deletion/deletion (D...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091502320798321
更新日期:2002-01-01 00:00:00
abstract::Empowerment plays significant roles in the complex management of type 2 diabetes. International guidelines have provided recommendations on management of Muslims who fast during Ramadan. However, there remains a lack of patient-centered epistemic tool to empower healthcare providers and patients in managing diabetes d...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1089/dia.2018.0159
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Continuous glucose monitoring is a useful tool for the achievement of improved glucose control in patients with diabetes. We tested the ability of a novel noninvasive continuous glucose monitor to track glucose excursions. METHODS:The novel noninvasive Aprise sensor (Glucon Inc., Boulder, CO) utilizes the p...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/dia.2006.0059
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Because strict glucose control is important for reducing the complications of diabetes, the self-monitoring of blood glucose is one of the fundamental treatment modalities. Many glucometers have been developed. In the present study, we evaluated a new glucometer: GlucoDr Plus (Allmedicus, Anyang, Gyeonggi-do...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0134
更新日期:2010-04-01 00:00:00
abstract:UNLABELLED:Abstract Objective: Controlled inpatient studies on the effects of food, physical activity (PA), and insulin dosing on glucose excursions exist, but such outpatient data are limited. We report here outpatient data on glucose excursions and its key determinants over 5 days in 30 adolescents with type 1 diab...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2012.0053
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:A brief history of the field of human factors research is covered, along with how this discipline is leveraged within medical device companies, to eliminate design flaws in products, in order to make them safe and effective for human use. The way in which human factors research was used to develop the t:slim...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1089/dia.2013.0098
更新日期:2013-10-01 00:00:00
abstract::Type 2 diabetes is characterized by insulin resistance and progressive β-cell deterioration. As β-cell function declines, most patients with type 2 diabetes treated with oral agents, in monotherapy or combination, will require insulin therapy. Addition of basal insulin (glargine, detemir, or NPH/neutral protamine lisp...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2011.0001
更新日期:2011-06-01 00:00:00
abstract::This study was designed to assess the frequency of the dawn phenomenon in patients with type 2 diabetes. A secondary aim was to examine the influence of varying treatment regimens on the frequency of the dawn phenomenon. The dawn phenomenon was defined as a rise in plasma glucose levels of > or = 0.5 mmol/L (10 mg/dL)...
journal_title:Diabetes technology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1089/152091502320798213
更新日期:2002-01-01 00:00:00
abstract::Continuous glucose monitoring (CGM) is a new tool that has recently become available to people with diabetes. Properly designing and conducting trials in order to answer important questions regarding the clinical usefulness of CGM is very difficult and fraught with many confounding variables and unique challenges. Ini...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2009.0012
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Performance of continuous glucose monitors (CGMs) may be lower when glucose levels are changing rapidly, such as occurs during physical activity. Our aim was to evaluate accuracy of a current-generation CGM during moderate-intensity exercise in type 1 diabetes (T1D) pregnancy. SUBJECTS AND METHODS:As part o...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2012.0292
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The quantitative analysis of glucose time-series can greatly help the management of diabetes. In particular, a static nonlinear transformation, which symmetrizes the distribution of glucose levels by bringing them in the so-called risk space, was proposed previously for both self-monitoring blood glucose and...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2011.0006
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:This study was designed to assess the accuracy, reliability, and contribution to clinical decision-making of two commercially available continuous glucose monitoring (CGM) devices using a novel analytical approach. STUDY DESIGN:Eleven individuals with type 1 diabetes and five with type 2 diabetes wore a Gua...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/dia.2008.0041
更新日期:2009-01-01 00:00:00
abstract::The foreign body capsule that forms around implanted devices such as glucose sensors is hypovascular and has limited permeability to glucose. Such a capsule may function better if well vascularized. We hypothesized that capsular vascularization achieved by local release of vascular endothelial growth factor (VEGF) wou...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091504773731320
更新日期:2004-04-01 00:00:00
abstract::Type 2 diabetes is thought to develop as a result of progressive beta-cell dysfunction in the setting of insulin resistance, leading to increased risks of microvascular and macrovascular complications. Type 2 diabetes is currently treated with diet and exercise, followed by oral drug therapy, and finally exogenous ins...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2006.8.385
更新日期:2006-06-01 00:00:00
abstract::The microdialysis technique allows extraction of substances (e.g., glucose) from fluids in the human body for quantitative measurements ex vivo. The microdialysis catheter can be inserted in many different tissues; for continuous glucose monitoring it is most often implanted in the subcutaneous fat tissue in the abdom...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/152091503322250578
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Glucose monitoring based on sampling skin interstitial fluid (ISF) is being developed as an alternative to fingerstick blood glucose monitoring. Time delays between rapidly changing levels of glucose in blood and interstitial fluid have been reported in the literature to be between 5 and 20 minutes. This stu...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
doi:10.1089/152091599317530
更新日期:1999-04-01 00:00:00