Tags

Type your tag names separated by a space and hit enter

Closed-loop subcutaneous insulin infusion algorithm with a short-acting insulin analog for long-term clinical application of a wearable artificial endocrine pancreas.
Front Med Biol Eng. 1997; 8(3):197-211.FM

Abstract

Considering the management and safety of the insulin delivery route when a wearable artificial endocrine pancreas is applied to ambulatory diabetic patients on a long-term basis, we developed a s.c. insulin infusion algorithm by analyzing the dynamics of a s.c. injected short-acting insulin analog (Insulin Lispro) by a three-compartment model. Principally the insulin infusion algorithm was developed as a transfer function with the first-order delay in both proportional and derivative actions to blood glucose concentrations. The parameters for this algorithm were calculated to simulate a physiological plasma insulin profile as closely as possible. By applying this algorithm with regular insulin, diabetic patients showed a 2 h postprandial hyperglycemia and a delayed hyperinsulinemia, followed by hypoglycemic episodes 4-5 h after oral glucose load, just as observed in the computer simulation study. However, using Insulin Lispro, a near-physiological glycemic control (postprandial blood glucose of 153.1 +/- 8.3 mg/100 ml at 60 min and 90.3 +/- 7.1 mg/100 ml at 180 min, respectively) could be achieved without showing any delayed hyperinsulinemia or hypoglycemia. Daily glycemic excursions were also controlled near-physiologically and although the daily insulin requirement (731.7 +/- 160.5 mU/kg/day) was slightly higher, it was not significantly different from that with i.v. insulin infusion (622.3 +/- 142.6 mU/kg/day). These results indicate that the application of s.c. insulin infusion algorithm with Insulin Lispro is feasible for long-term glycemic control with a wearable artificial endocrine pancreas in ambulatory diabetic patients.

Authors+Show Affiliations

Department of Metabolic Medicine, Kumamoto University School of Medicine, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9444512

Citation

Shimoda, S, et al. "Closed-loop Subcutaneous Insulin Infusion Algorithm With a Short-acting Insulin Analog for Long-term Clinical Application of a Wearable Artificial Endocrine Pancreas." Frontiers of Medical and Biological Engineering : the International Journal of the Japan Society of Medical Electronics and Biological Engineering, vol. 8, no. 3, 1997, pp. 197-211.
Shimoda S, Nishida K, Sakakida M, et al. Closed-loop subcutaneous insulin infusion algorithm with a short-acting insulin analog for long-term clinical application of a wearable artificial endocrine pancreas. Front Med Biol Eng. 1997;8(3):197-211.
Shimoda, S., Nishida, K., Sakakida, M., Konno, Y., Ichinose, K., Uehara, M., Nowak, T., & Shichiri, M. (1997). Closed-loop subcutaneous insulin infusion algorithm with a short-acting insulin analog for long-term clinical application of a wearable artificial endocrine pancreas. Frontiers of Medical and Biological Engineering : the International Journal of the Japan Society of Medical Electronics and Biological Engineering, 8(3), 197-211.
Shimoda S, et al. Closed-loop Subcutaneous Insulin Infusion Algorithm With a Short-acting Insulin Analog for Long-term Clinical Application of a Wearable Artificial Endocrine Pancreas. Front Med Biol Eng. 1997;8(3):197-211. PubMed PMID: 9444512.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Closed-loop subcutaneous insulin infusion algorithm with a short-acting insulin analog for long-term clinical application of a wearable artificial endocrine pancreas. AU - Shimoda,S, AU - Nishida,K, AU - Sakakida,M, AU - Konno,Y, AU - Ichinose,K, AU - Uehara,M, AU - Nowak,T, AU - Shichiri,M, PY - 1997/1/1/pubmed PY - 1998/1/28/medline PY - 1997/1/1/entrez SP - 197 EP - 211 JF - Frontiers of medical and biological engineering : the international journal of the Japan Society of Medical Electronics and Biological Engineering JO - Front Med Biol Eng VL - 8 IS - 3 N2 - Considering the management and safety of the insulin delivery route when a wearable artificial endocrine pancreas is applied to ambulatory diabetic patients on a long-term basis, we developed a s.c. insulin infusion algorithm by analyzing the dynamics of a s.c. injected short-acting insulin analog (Insulin Lispro) by a three-compartment model. Principally the insulin infusion algorithm was developed as a transfer function with the first-order delay in both proportional and derivative actions to blood glucose concentrations. The parameters for this algorithm were calculated to simulate a physiological plasma insulin profile as closely as possible. By applying this algorithm with regular insulin, diabetic patients showed a 2 h postprandial hyperglycemia and a delayed hyperinsulinemia, followed by hypoglycemic episodes 4-5 h after oral glucose load, just as observed in the computer simulation study. However, using Insulin Lispro, a near-physiological glycemic control (postprandial blood glucose of 153.1 +/- 8.3 mg/100 ml at 60 min and 90.3 +/- 7.1 mg/100 ml at 180 min, respectively) could be achieved without showing any delayed hyperinsulinemia or hypoglycemia. Daily glycemic excursions were also controlled near-physiologically and although the daily insulin requirement (731.7 +/- 160.5 mU/kg/day) was slightly higher, it was not significantly different from that with i.v. insulin infusion (622.3 +/- 142.6 mU/kg/day). These results indicate that the application of s.c. insulin infusion algorithm with Insulin Lispro is feasible for long-term glycemic control with a wearable artificial endocrine pancreas in ambulatory diabetic patients. SN - 0921-3775 UR - https://www.unboundmedicine.com/medline/citation/9444512/Closed_loop_subcutaneous_insulin_infusion_algorithm_with_a_short_acting_insulin_analog_for_long_term_clinical_application_of_a_wearable_artificial_endocrine_pancreas_ L2 - https://ClinicalTrials.gov/search/term=9444512 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -