Administrative Data

Project reference: DPI2010-20764-C02-01
Title: New strategies for postprandial glycemic control using insulin pump therapy in type 1 diabetes – CLOSEDLOOP4MEAL
Participating centers: Coordinated project
Subproject 1: Universitat Politècnica de València (coordinator);
Subproject 2: Universitat de Girona
Principal Investigator: Jorge Bondia (coordinator); Josep Vehí
Funded by: Ministerio de Ciencia e Innovación
Duration: 01/01/2011-31/12/2014
Funding awarded: Subproject 1: €267,410.00; Subproject 2: €223,850.00

Project Summary

Diabetes is a chronic disease characterized by absolute or relative insulin deficiency (type 1 diabetes mellitus and type 2 diabetes mellitus, respectively). The total number of diabetics is predicted to rise from 284.6 million in 2010 to 438.4 million in 2030. The cost of diabetes in the EU accounts for more than 10% of healthcare expenditure in most countries. Compared to daily insulin injections, continuous subcutaneous insulin infusion (CSII) via an insulin pump has been shown to be effective in reducing HbA1c (an index of mean glycemic control) in adults with type 1 diabetes; however, hypoglycemic episodes are not reduced. In the last two decades, technological progress has revived research into closed-loop glucose monitoring systems (artificial pancreas) combining an insulin pump and a continuous glucose monitor (CGM) for more effective treatment in subjects with type 1 diabetes. Although satisfactory clinical results have been reported for nocturnal monitoring, postprandial (after a meal) monitoring remains an open issue due to overcorrection by the monitor, leading to hypoglycemia. The lack of accuracy of current continuous glucose monitors, especially in hypoglycemia, has also been identified as a limiting factor in the development of an artificial pancreas.

The overall objective of this project is therefore the development of new, efficient, and safe strategies for postprandial glucose control in type 1 diabetics, with the goal of alleviating the complications of hypoglycemia. This project will focus on pump-based therapies, both open-loop (CSII) and closed-loop (artificial pancreas). This will be achieved through the following specific objectives:

Objective 1. Better understand the effect of a mixed meal on blood glucose.

Objective 2. Develop new, robust control strategies to efficiently compensate for the effects of meals without the risk of hypoglycemia.

Objective 3. To better understand the dynamic relationship between plasma and interstitial glucose to develop new CGM calibration algorithms with improved accuracy and hypoglycemia detection.

Objective 4. Develop fault-detection algorithms for insulin infusion monitoring. It is expected that improvements in control algorithms, measurement accuracy, and fault-detection systems will achieve the performance and safety required for automatic postprandial monitoring in type 1 diabetes.

Researchers

Hospital Francesc de Borja de Gandía

• Paolo Rossetti

Hospital Clínic de Barcelona

• Ignacio Conget
• Marga Giménez
• Carmen Quirós