Mauseth Richard, Wang Youqing, Dassau Eyal, Kircher Robert, Matheson Donald, Zisser Howard, Jovanovic Lois, Doyle Francis J
Division of Pediatric Endocrinology, Department of Pediatrics, University of Washington, Seattle, Washington, USA.
J Diabetes Sci Technol. 2010 Jul 1;4(4):913-22. doi: 10.1177/193229681000400422.
Physicians tailor insulin dosing based on blood glucose goals, response to insulin, compliance, lifestyle, eating habits, daily schedule, and fear of and ability to detect hypoglycemia.
We introduce a method that allows a physician to tune a fuzzy logic controller (FLC) artificial pancreas (AP) for a particular patient. It utilizes the physician's judgment and weighing of various factors. The personalization factor (PF) is a scaling of the dose produced by the FLC and is used to customize the dosing. The PF has discrete values of 1 through 5. The proposed method was developed using a database of results from 30 University of Virginia/Padova Metabolic Simulator in silico subjects (10 adults, 10 adolescents, and 10 children). Various meal sizes and timing were used to provide the physician information on which to base an initial dosing regimen and PF. Future decisions on dosing aggressiveness using the PF would be based on the patient's data at follow-up.
Three examples of a wide variation in diabetes situations are given to illustrate the physician's thought process when initially configuring the AP system for a specific patient.
Fuzzy logic controllers are developed by encoding human expertise into the design of the controller. The FLC methodology allows for the real-time scaling of doses without compromising the integrity of the dosing rules matrix. The use of the PF to individualize the AP system is enabled by the fuzzy logic development methodology.
医生根据血糖目标、对胰岛素的反应、依从性、生活方式、饮食习惯、日常安排以及对低血糖的恐惧和检测能力来调整胰岛素剂量。
我们介绍一种方法,该方法允许医生为特定患者调整模糊逻辑控制器(FLC)人工胰腺(AP)。它利用医生对各种因素的判断和权衡。个性化因子(PF)是FLC产生的剂量的缩放比例,用于定制给药剂量。PF具有1到5的离散值。所提出的方法是使用来自弗吉尼亚大学/帕多瓦代谢模拟器的30个虚拟受试者(10名成年人、10名青少年和10名儿童)的结果数据库开发的。使用了各种餐量和时间安排,为医生提供用于确定初始给药方案和PF的信息。未来使用PF进行给药积极性的决策将基于随访时患者的数据。
给出了三个糖尿病情况差异很大的例子,以说明医生在为特定患者初始配置AP系统时的思维过程。
模糊逻辑控制器是通过将人类专业知识编码到控制器设计中而开发的。FLC方法允许在不损害给药规则矩阵完整性的情况下实时缩放剂量。模糊逻辑开发方法使得能够使用PF对AP系统进行个性化设置。