In this brief, an output feedback continuous twisting algorithm is applied to solve the problem of glucose regulation in critically ill patients affected with type 1 diabetes mellitus. The proposed approach copes with disturbances coming from intrapatient and interpatient variability and does not need meal announcements. The blood glucose measurement and insulin infusion are via intravenous. The proposed algorithm regulates blood glucose and keeps it in the normoglycemia range, i.e., 70-180 mg/dl without nursing intervention. Therefore, the workload at the intensive care unit is alleviated. Besides, we provide a criterion to set the output feedback continuous twisting algorithm gains, which may be used for individualizing the insulin therapy. The approach is validated in the Universities of Virginia and Padua (UVA/Padua) metabolic simulator for ten in silico adult patients with unannounced meal intake. The results show excellent performance as well as minimal risk of hyperglycemic and hypoglycemic events. In addition, an open-loop study case is presented to evidence the advantages of output feedback continuous twisting algorithm over a traditional brief-based protocol in terms of nurse workload mitigation.
Bibliographical noteFunding Information:
This work was supported in part by the ECOS Nord Project under Grant M18M01, in part by SEP-CONACYT-ECOS-ANUIES under Grant 296692, and in part by the French National Agency for Research under Grant DIABLO ANR-18-CE17-0005-01. The work of Roberto Franco Jaramillo and Héctor Ríos was supported in part by CONACYT CVU under Grant 772057, in part by Cátedras CONACYT CVU under Grant 270504 Project 922, and in part by TecNM Projects. The work of Alejandra Ferreira de Loza was supported by Cátedras CONACYT CVU under Grant 166403, Project 1537.
© 1993-2012 IEEE.
- Diabetes mellitus
- glucose regulation
- in silico validation
- sliding mode control