Adaptive controllers for intelligent monitoring.

The project we describe here is aimed at assisting out-patients affected by Insulin Dependent Diabetes Mellitus. Our approach exploits the usual scheme of diabetic patients management, based on (i) a periodic evaluation of patients' metabolic control performed by the physician, and (ii) patient-tailored tables for self-adjustments of insulin dosages. Following this scheme we have defined a system built on a two-level architecture. The High Level Module exploits both medical knowledge and clinical information in order to assess an insulin protocol, defined in terms of insulin timing, type, and total amount. The High Level Module exchanges information with the Low Level Module in order to define the control actions to be taken at the low level, as well as to periodically evaluate protocol adequacy on the basis of patient data. The goal of the Low Level Module, whose characteristics can be adaptively modified by the High Level Module, is to suggest the next insulin dosage, depending on the actual blood glucose measurement and a certain pre-defined insulin delivery protocol. The Level Control Module is based on an adaptive controller, consisting of a Fuzzy Set Controller and an ARX (Autoregressive eXogenous input) Model. The scheme here presented may be conveniently viewed in a telemedicine context, in which the low level controller is implemented on a portable device communicating to the high level controller, implemented on a remote computer. A preliminary assessment has been performed, analyzing a data set of 60 patients provided by the American Association of Artificial Intelligence, Artificial Intelligence in Medicine Subgroup, and the implementation of the system is currently in progress.