Seeking solutions for the artificial pancreas: new methods for improving continuous glucose monitoring and closed loop postprandial glycaemic control
Project reference: FP7-PEOPLE-2009-IEF, ref 252085
Title: Seeking solutions for the artificial pancreas: new methods for improving continuous glucose monitoring and closed loop postprandial glycaemic control – SOLARE
Participating centers: Universitat Politècnica de València
Principal investigator: Jorge Bondia (Host); Paolo Rossetti (Fellow)
Funded by: European Community
Funding awared: €160,793.00
In the last two decades, technological progresses have fuelled research on closed-loop glucose control systems, the so-called artificial pancreas, for effective treatment of type 1 diabetic subjects. Preliminary studies using off-the-shelf insulin pumps and continuous glucose monitoring (CGM) sensors have suggested that in research settings, closed-loop systems that automatically dispense insulin can achieve better control of glucose levels than open-loop systems in which a person makes dosing decisions. Such promising results prompted the Juvenile Diabetes Research Foundation (JDRF) to push the research forward by launching its Artificial Pancreas Project 3 years ago, and the US Food and Drug Administration (FDA) to designate the artificial pancreas as a priority within its Critical Path Initiative. However, so far only a few prototypes have been developed and tested in controlled clinical settings. In fact, several challenges do still exist:
1. Coping with big disturbances affecting the system, such as meals, stress and exercise;
2. Robustness face to the great variability of patient’s physiological behaviour;
3. Accuracy and reliability of continuous glucose monitors, that must be improved to a higher degree;
4. Safety of insulin pumps and detection of faults;
5. Adequate correction for the slow responsiveness of controllers due to delays in the control loop.
The general objective of this project is to get an efficient and safe closed-loop system to control glucose concentration after a meal perturbation. This will be achieved through:
1. The development of new feedback strategies for post-prandial glycaemic control. Assessment and clinical validation of a new algorithm for optimization of post-prandial (post-meal) glucose control will be carried out. Clinical results will drive the development of new closed-loop strategies to counteract efficiently meal perturbations without hypoglycaemia risk.
2. The improvement of accuracy and reliability of sensors for continuous glucose monitoring to detect hypoglycaemia. CGM devices estimate plasma glucose from measurements in the interstitium. However, relationship between plasma and interstitial glucose is not fully understood, especially under dynamic conditions. In this project, the relationship between plasma and interstitial glucose will be evaluated and modelled, with the specific aim to develop new calibration strategies improving CGM performance in hypoglycaemia.
It is expected that the improvement in control algorithms and measurement accuracy will allow getting the performance and safety required for automated post-meal control.
Universitat Politècnica de València:
- Jorge Bondia (host)
- Paolo Rossetti (fellow)
Hospital Clínico de Valencia
- F. Javier Ampudia