In Silico Testing and in Vivo Experiments with Closed-Loop Control of Blood Glucose in Diabetes

摘要

Diabetes technology is currently focused on developing the artificial pancreas - a closed-loop control algorithm linking continuous glucose monitoring (CGM) and subcutaneous insulin delivery. The future development of the artificial pancreas will be greatly accelerated by employing mathematical modeling and computer simulation. Such in silico testing would provide direction for clinical studies, outruling ineffective control scenarios in a cost-effective manner. Thus, computer simulation testing of closed-loop control algorithms is regarded as a prerequisite to clinical trials of artificial pancreas. We therefore present a system for in silico testing of control algorithms consisting of a simulated human metabolic system, simulated CGM and simulated insulin pump. Further, we present an overview of current in vivo clinical trials of CGM and closed-loop control and illustrate the positive effects of CGM by data collected in a clinical trial using the Freestyle Navigator (Abbott Diabetes Care, Alameda, CA).