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Validation of closed-loop subcutaneous insulin infusion algorithm--application of subcutaneous insulin absorption kinetics.
Diabetes Res. 1987 Aug; 5(4):193-8.DR

Abstract

For long-term glycemic normalization with a closed-loop control system, a subcutaneous insulin infusion algorithm has been developed based on the pharmacokinetics of subcutaneously administered insulin. A 3-compartmental model was applied to mathematically express the relation between the insulin injected subcutaneously as an input and the plasma insulin response as an output. A computer simulation study using this model showed that the following insulin infusion algorithm is feasible for closed-loop glycemic control by selecting appropriate parameters (Kp/Kd/Kc = 0.0056/0.92/-0.11), IIR(t) = Kp G(t)+Kd d G(t)/dt+Kc, where IIR(t) is the subcutaneous insulin infusion rate at time t (min), G(t) is the blood glucose concentration and Kp, Kd, Kc are the constants. In 5 pancreatectomized dogs, subcutaneous insulin infusion with this algorithm made it possible to keep postprandial glycemic levels after oral glucose load (2 g/kg) at 168 +/- 14 mg/dl (mean +/- SEM) in 60 min and maintained normoglycemia from 180 to 300 min with the total amount of infused insulin being 0.14 +/- 0.019 U/kg. In 5 insulin-dependent diabetic patients, the peaks of postprandial glycemic levels after meal load (450 kcal) were controlled to 176 +/- 36 mg/dl at 90 min and were reduced to 98 +/- 13 mg/dl at 300 min with the total amount of infused insulin being 0.172 +/- 0.063 U/kg. The mean peak plasma insulin level was 49 +/- 11 microU/ml at 90 min. These results indicate the clinical controllability of postprandial glycemia with the closed-loop subcutaneous insulin infusion algorithm in diabetic patients.

Authors+Show Affiliations

First Department of Medicine, Osaka University, Medical School, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

3311559

Citation

Asakawa, N, et al. "Validation of Closed-loop Subcutaneous Insulin Infusion Algorithm--application of Subcutaneous Insulin Absorption Kinetics." Diabetes Research (Edinburgh, Scotland), vol. 5, no. 4, 1987, pp. 193-8.
Asakawa N, Saito Y, Yamasaki Y, et al. Validation of closed-loop subcutaneous insulin infusion algorithm--application of subcutaneous insulin absorption kinetics. Diabetes Res. 1987;5(4):193-8.
Asakawa, N., Saito, Y., Yamasaki, Y., Kawamori, R., & Shichiri, M. (1987). Validation of closed-loop subcutaneous insulin infusion algorithm--application of subcutaneous insulin absorption kinetics. Diabetes Research (Edinburgh, Scotland), 5(4), 193-8.
Asakawa N, et al. Validation of Closed-loop Subcutaneous Insulin Infusion Algorithm--application of Subcutaneous Insulin Absorption Kinetics. Diabetes Res. 1987;5(4):193-8. PubMed PMID: 3311559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of closed-loop subcutaneous insulin infusion algorithm--application of subcutaneous insulin absorption kinetics. AU - Asakawa,N, AU - Saito,Y, AU - Yamasaki,Y, AU - Kawamori,R, AU - Shichiri,M, PY - 1987/8/1/pubmed PY - 1987/8/1/medline PY - 1987/8/1/entrez SP - 193 EP - 8 JF - Diabetes research (Edinburgh, Scotland) JO - Diabetes Res VL - 5 IS - 4 N2 - For long-term glycemic normalization with a closed-loop control system, a subcutaneous insulin infusion algorithm has been developed based on the pharmacokinetics of subcutaneously administered insulin. A 3-compartmental model was applied to mathematically express the relation between the insulin injected subcutaneously as an input and the plasma insulin response as an output. A computer simulation study using this model showed that the following insulin infusion algorithm is feasible for closed-loop glycemic control by selecting appropriate parameters (Kp/Kd/Kc = 0.0056/0.92/-0.11), IIR(t) = Kp G(t)+Kd d G(t)/dt+Kc, where IIR(t) is the subcutaneous insulin infusion rate at time t (min), G(t) is the blood glucose concentration and Kp, Kd, Kc are the constants. In 5 pancreatectomized dogs, subcutaneous insulin infusion with this algorithm made it possible to keep postprandial glycemic levels after oral glucose load (2 g/kg) at 168 +/- 14 mg/dl (mean +/- SEM) in 60 min and maintained normoglycemia from 180 to 300 min with the total amount of infused insulin being 0.14 +/- 0.019 U/kg. In 5 insulin-dependent diabetic patients, the peaks of postprandial glycemic levels after meal load (450 kcal) were controlled to 176 +/- 36 mg/dl at 90 min and were reduced to 98 +/- 13 mg/dl at 300 min with the total amount of infused insulin being 0.172 +/- 0.063 U/kg. The mean peak plasma insulin level was 49 +/- 11 microU/ml at 90 min. These results indicate the clinical controllability of postprandial glycemia with the closed-loop subcutaneous insulin infusion algorithm in diabetic patients. SN - 0265-5985 UR - https://www.unboundmedicine.com/medline/citation/3311559/Validation_of_closed_loop_subcutaneous_insulin_infusion_algorithm__application_of_subcutaneous_insulin_absorption_kinetics_ DB - PRIME DP - Unbound Medicine ER -