Kan S, Onodera H, Furutani E, Aung T, Araki M, Nishimura H, Maetani S, Imamura M
Department of Surgery and Surgical Basic Science, Kyoto University, Japan.
ASAIO J. 2000 Nov-Dec;46(6):657-62. doi: 10.1097/00002480-200011000-00004.
We developed a novel blood glucose control system, using a model predictive method, to achieve optimal control of the blood glucose level in severely diabetic or pancreatectomized patients. This system is designed to predict glucose level changes in advance, considering delayed response time and the administered doses of insulin. This method is also designed to calculate the most appropriate insulin infusion rate by considering differences in individual response to insulin. In this study, we compared our system with a conventional proportional and differential controller (PD controller) to determine whether the new system could regulate the glucose level efficiently in pancreatectomized dogs. The model predictive control method resulted in a significant reduction of mean insulin infusion rate compared with the conventional PD controller (0.71 mU/kg per min vs. 1.81 mU/kg per min, p = 0.0005), when the glucose level in both methods reached the planned target level (100 mg/dl). The new system also tended to have a reduced mean glucose infusion rate for compensating for overshooting of the glucose level compared with the PD controller (0.7 mg/kg per min vs. 1.1 mg/kg per min, p = 0.16). These results indicate that the new system should be a useful tool for regulating the glucose level in severely diabetic patients.
我们开发了一种新型血糖控制系统，采用模型预测方法，以实现对重度糖尿病患者或胰腺切除患者血糖水平的最佳控制。该系统旨在提前预测血糖水平变化，同时考虑延迟反应时间和胰岛素给药剂量。此方法还旨在通过考虑个体对胰岛素反应的差异来计算最合适的胰岛素输注速率。在本研究中，我们将我们的系统与传统的比例微分控制器（PD控制器）进行比较，以确定新系统是否能在胰腺切除的狗身上有效地调节血糖水平。当两种方法的血糖水平达到计划目标水平（100mg/dl）时，与传统的PD控制器相比，模型预测控制方法导致平均胰岛素输注速率显著降低（0.71mU/kg每分钟对1.81mU/kg每分钟，p = 0.0005）。与PD控制器相比，新系统在补偿血糖水平过冲方面也倾向于降低平均葡萄糖输注速率（0.7mg/kg每分钟对1.1mg/kg每分钟，p = 0.16）。这些结果表明，新系统应该是调节重度糖尿病患者血糖水平的有用工具。
