Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy.
Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy.
Comput Methods Programs Biomed. 2019 Apr;171:133-140. doi: 10.1016/j.cmpb.2016.06.006. Epub 2016 Jul 5.
The inter-subject variability characterizing the patients affected by type 1 diabetes mellitus makes automatic blood glucose control very challenging. Different patients have different insulin responses, and a control law based on a non-individualized model could be ineffective. The definition of an individualized control law in the context of artificial pancreas is currently an open research topic. In this work we consider two novel identification approaches that can be used for individualizing linear glucose-insulin models to a specific patient.
The first approach belongs to the class of black-box identification and is based on a novel kernel-based nonparametric approach, whereas the second is a gray-box identification technique which relies on a constrained optimization and requires to postulate a model structure as prior knowledge. The latter is derived from the linearization of the average nonlinear adult virtual patient of the UVA/Padova simulator. Model identification and validation are based on in silico data collected during simulations of clinical protocols designed to produce a sufficient signal excitation without compromising patient safety. The identified models are evaluated in terms of prediction performance by means of the coefficient of determination, fit, positive and negative max errors, and root mean square error.
Both identification approaches were used to identify a linear individualized glucose-insulin model for each adult virtual patient of the UVA/Padova simulator. The resulting model simulation performance is significantly improved with respect to the performance achieved by a linear average model.
The approaches proposed in this work have shown a good potential to identify glucose-insulin models for designing individualized control laws for artificial pancreas.
1 型糖尿病患者的个体间变异性使得自动血糖控制极具挑战性。不同的患者有不同的胰岛素反应,基于非个体化模型的控制律可能无效。人工胰腺中个体化控制律的定义目前仍是一个开放的研究课题。在这项工作中,我们考虑了两种新的识别方法,可用于将线性血糖-胰岛素模型个体化到特定患者。
第一种方法属于黑盒识别方法,基于一种新的基于核的非参数方法,而第二种是一种灰盒识别技术,依赖于约束优化,并需要假设模型结构作为先验知识。后者源自 UVA/Padova 模拟器的平均非线性成人虚拟患者的线性化。模型识别和验证基于在模拟临床方案期间收集的虚拟数据,这些方案旨在在不危及患者安全的情况下产生足够的信号激励。所识别的模型通过决定系数、拟合度、正负最大误差和均方根误差来评估预测性能。
两种识别方法均用于为 UVA/Padova 模拟器的每个成人虚拟患者识别线性个体化血糖-胰岛素模型。与线性平均模型相比,所得到的模型模拟性能得到了显著提高。
本文提出的方法在设计人工胰腺个体化控制律方面具有很好的潜力,可用于识别血糖-胰岛素模型。