PMID- 23439180
OWN - NLM
STAT- MEDLINE
DCOM- 20130828
LR  - 20211021
IS  - 1932-2968 (Electronic)
IS  - 1932-2968 (Linking)
VI  - 7
IP  - 1
DP  - 2013 Jan 1
TI  - In silico evaluation of an artificial pancreas combining exogenous 
      ultrafast-acting technosphere insulin with zone model predictive control.
PG  - 215-26
AB  - BACKGROUND: Because of the slow pharmacokinetics of subcutaneous (SC) insulin, 
      avoiding postprandial hyperglycemia has been a major challenge for an artificial 
      pancreas (AP) using SC insulin without a meal announcement. METHODS: A 
      semiautomated AP with Technosphere(R) Insulin (TI; MannKind Corporation, Valencia, 
      CA) was designed to combine pulmonary and SC insulin. Manual inhalation of 10 U 
      ultrafast-absorbing TI at mealtime delivers the first, or cephalic, phase of 
      insulin, and an SC insulin pump controlled by zone model predictive controller 
      delivers second-phase and basal insulin. This AP design was evaluated on 100 in 
      silico subjects from the University of Virginia/Padova metabolic simulator using 
      a protocol of two 50 g carbohydrate (CHO) meals and two 15 g CHO snacks. RESULTS: 
      Simulation analysis shows that the semiautomated AP with TI provides 32% and 16% 
      more time in the controller target zone (80-140 mg/dl) during the 4 h 
      postprandial period, with 39 and 20 mg/dl lower postprandial blood glucose peak 
      on average than the pure feedback AP and the AP with manual feed-forward SC 
      bolus, respectively. No severe hypoglycemia (<50 mg/dl) was observed in any 
      cases. CONCLUSIONS: The semiautomated AP with TI provides maximum time in the 
      clinically accepted region when compared with pure feedback AP and AP with manual 
      feed-forward SC bolus. Furthermore, the semiautomated AP with TI provides a 
      flexible operation (optional TI inhalation) with minimal user interaction, where 
      the controller design can be tailored to specific user needs and abilities to 
      interact with the device.
CI  - (c) 2012 Diabetes Technology Society.
FAU - Lee, Justin J
AU  - Lee JJ
AD  - Department of Chemical Engineering, University of California, Santa Barbara, 
      Santa Barbara, California 93106-5080, USA.
FAU - Dassau, Eyal
AU  - Dassau E
FAU - Zisser, Howard
AU  - Zisser H
FAU - Harvey, Rebecca A
AU  - Harvey RA
FAU - Jovanovic, Lois
AU  - Jovanovic L
FAU - Doyle, Francis J 3rd
AU  - Doyle FJ 3rd
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130101
PL  - United States
TA  - J Diabetes Sci Technol
JT  - Journal of diabetes science and technology
JID - 101306166
RN  - 0 (Insulin)
SB  - IM
MH  - *Algorithms
MH  - *Computer Simulation
MH  - Drug Delivery Systems/*methods
MH  - Insulin/*administration & dosage
MH  - *Pancreas, Artificial
MH  - Time Factors
PMC - PMC3692236
EDAT- 2013/02/27 06:00
MHDA- 2013/08/29 06:00
PMCR- 2014/01/01
CRDT- 2013/02/27 06:00
PHST- 2013/02/27 06:00 [entrez]
PHST- 2013/02/27 06:00 [pubmed]
PHST- 2013/08/29 06:00 [medline]
PHST- 2014/01/01 00:00 [pmc-release]
AID - dst.7.1.0215 [pii]
AID - 10.1177/193229681300700127 [doi]
PST - epublish
SO  - J Diabetes Sci Technol. 2013 Jan 1;7(1):215-26. doi: 10.1177/193229681300700127.