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"E##D"``),.4B\a5\A9D\Gn.-a2?$fLCRf/H_.k 1wF4C0 ?>e$7 I_]( !6d`3ǐ`1 endstream endobj startxref 116 %%EOF 65 0 obj <>stream Acrobat Distiller 9.0.0 (Windows) diabetes; sensor; algorithm; closed loop PScript5.dll Version 5.2.2 2009-03-12T15:13:29+01:00 2009-03-12T15:11:36+01:00 2009-03-12T15:13:29+01:00 application/pdf A Review of Closed-Loop Algorithms for Glycemic Control in the Treatment of Type 1 Diabetes Joseph El Youssef Jessica Castle W. Kenneth Ward With the discovery of insulin came a deeper understanding of therapeutic options for one of the most devastating chronic diseases of the modern era, diabetes mellitus. The use of insulin in the treatment of diabetes, especially in those with severe insulin deficiency (type 1 diabetes), with multiple injections or continuous subcutaneous infusion, has been largely successful, but the risk for short term and long term complications remains substantial. Insulin treatment decisions are based on the patient’s knowledge of meal size, exercise plans and the intermittent knowledge of blood glucose values. As such, these are open loop methods that require human input. The idea of closed loop control of diabetes treatment is quite different: automated control of a device that delivers insulin (and possibly glucagon or other medications) and is based on continuous or very frequent glucose measurements. Closed loop insulin control for type 1 diabetes is not new but is far from optimized. The goal of such a system is to avoid short-term complications (hypoglycemia) and long-term complications (diseases of the eyes, kidneys, nerves and cardiovascular system) by mimicking the normal insulin secretion pattern of the pancreatic beta cell. A control system for automated diabetes treatment consists of three major components, (1) a glucose sensing device that serves as the afferent limb of the system; (2) an automated control unit that uses algorithms which acquires sensor input and generates treatment outputs; and (3) a drug delivery device (primarily for delivery of insulin), which serves as the system’s efferent limb. There are several major issues that highlight the difficulty of interacting with the complex unknowns of the biological world. For example, development of accurate continuous glucose monitors is crucial; the state of the art in 2009 is that such devices sometimes experience drift and are intended only to supplement information received from standard intermittent blo diabetes sensor algorithm closed loop uuid:7cceff03-8380-4e4c-ba47-9a5af645518a uuid:153f531d-3f03-448a-a7ce-1db2800c8483 False endstream endobj 108 0 obj <> endobj 126 0 obj <> endobj 127 0 obj <> endobj 128 0 obj <>/Filter/FlateDecode/ID[<848CA627EA5990FCD518E9C9A2440B25><6B84EEFE4454804CAE24C1AB57ADC114>]/Index[65 1 108 1 126 3]/Info 127 0 R/Length 31/Prev 116/Root 108 0 R/Size 129/Type/XRef/W[1 3 0]>>stream hbbd uH0V  `+D endstream endobj startxref 208324 %%EOF