Lam Z-H, Hwang K-S, Lee J-Y, Chase J G, Wake G C
Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, New Zealand.
Med Eng Phys. 2002 Dec;24(10):663-72. doi: 10.1016/s1350-4533(02)00147-9.
Close control of blood glucose levels significantly reduces vascular complications in Type I diabetes. A control method for the automation of insulin infusion that utilizes emerging technologies in blood glucose biosensors is presented. The controller developed provides tighter, more optimal control of blood glucose levels, while accounting for variation in patient response, insulin employed and sensor bandwidth. Particular emphasis is placed on controller simplicity and robustness necessary for medical devices and implants.A PD controller with heavy emphasis on the derivative term is found to outperform the typically used proportional-weighted controllers in glucose tolerance and multi-meal tests. Simulation results show reductions of over 50% in the magnitude and duration of blood glucose excursions from basal levels. A closed-form steady state optimal solution is also developed as a benchmark, and results in a flat glucose response. The impact and trade-offs associated with sensor bandwidth, sensor lag and proportional versus derivative-based control methods are illustrated. Overall, emerging blood glucose sensor technologies that enable frequent measurement are shown to enable more effective, automated control of blood glucose levels within a tight, acceptable range for Type I and II diabetic individuals.
严格控制血糖水平可显著降低 I 型糖尿病的血管并发症。本文提出了一种利用血糖生物传感器新兴技术实现胰岛素输注自动化的控制方法。所开发的控制器能更严格、更优化地控制血糖水平，同时考虑患者反应、所用胰岛素和传感器带宽的变化。特别强调了医疗设备和植入物所需的控制器简单性和鲁棒性。在葡萄糖耐量和多餐测试中，发现特别强调微分项的 PD 控制器优于通常使用的比例加权控制器。仿真结果表明，血糖从基础水平的波动幅度和持续时间减少了 50% 以上。还开发了一个闭式稳态最优解作为基准，其结果是血糖反应平稳。阐述了与传感器带宽、传感器滞后以及基于比例与微分项的控制方法相关的影响和权衡。总体而言，新兴的能实现频繁测量的血糖传感器技术显示，对于 I 型和 II 型糖尿病患者，能够在紧密且可接受的范围内更有效地自动控制血糖水平。
