Administrative Data

Project reference: DPI2007-66728-C02-01
Title: Closed-loop glycemic control in patients with type 1 diabetes mellitus and critically ill patients
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 Educación y Ciencia
Duration: 01/10/2007-01/10/2011
Funding awarded: Subproject 1: €195,415.00;
Subproject 2: €206,063.00

Project Summary

In the 1990s, it was demonstrated that any improvement in glycemic control translates into a reduced risk of developing chronic complications associated with diabetes. For this reason, normoglycemia has become the management goal for patients with type 1 diabetes mellitus. Furthermore, critically ill patients in the Intensive Care Unit are subject to significant morbidity and mortality. Recent advances in understanding the pathophysiology of these patients demonstrate how hyperglycemia can contribute to clinical outcomes. There is literature that points to the importance of achieving normoglycemia in these patients through insulin infusions to reduce mortality. Therefore, there is great social and economic interest in effective glycemic control.

The technology necessary for automatic blood glucose monitoring is expected to be available in four to five years, with continuous glucose monitoring currently being a limiting factor. Therefore, the study of effective blood glucose monitoring algorithms, the development of effective models of the glucoregulatory system, and their validation based on therapeutic criteria are of paramount importance.

Therefore, this project has two overall objectives: (1) the implementation of a clinical study to obtain experimental data that allow the development of models and their therapeutic validation; (2) the development of advanced control algorithms for closed-loop glycemic control in patients with T1DM and critically ill patients.

Interval and conjunctive techniques will be used to address the problem of intra- and interpatient variability. Finally, the use of counterregulatory signals such as glucagon or glucose in addition to insulin for monitoring will be explored.

Researchers

Hospital Clínico de Valencia

• F. Javier Ampudia

Hospital Francesc de Borja de Gandía

• Paolo Rossetti