Evidence mapPaperPMID 37864340Full record

ArticleJournal of diabetes science and technology2023

Performance Effect of Adjusting Insulin Sensitivity for Model-Based Automated Insulin Delivery Systems.

Marcela Moscoso-Vasquez, Chiara Fabris, Marc D Breton

Open access · greenAbstract read
In one paragraph

Article in Journal of diabetes science and technology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.4field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Marcela Moscoso-VasquezCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA.ORCID 0000-0003-4691-0096
Chiara FabrisCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA.
Marc D BretonCenter for Diabetes Technology, University of Virginia, Charlottesville, VA, USA.ORCID 0000-0001-7645-2693
University of Virginia · US

Funding

Advanced Artificial Pancreas Systems to Enable Fully Automated Glycemic Control in Type 1 Diabetes MellitusR01DK129553 · UNIVERSITY OF VIRGINIA · 2025 to 2025
$441k
NIDDK NIH HHS R01 DK129553
6 · The paper itself

Abstract

backgroundModel predictive control (MPC) has become one of the most popular control strategies for automated insulin delivery (AID) in type 1 diabetes (T1D). These algorithms rely on a prediction model to determine the best insulin dosing every sampling time. Although these algorithms have been shown to be safe and effective for glucose management through clinical trials, managing the ever-fluctuating relationship between insulin delivery and resulting glucose uptake (aka insulin sensitivity, IS) remains a challenge. We aim to evaluate the effect of informing an AID system with IS on the performance of the system.

methodThe University of Virginia (UVA) MPC control-based hybrid closed-loop (HCL) and fully closed-loop (FCL) system was used. One-day simulations at varying levels of IS were run with the UVA/Padova T1D Simulator. The AID system was informed with an estimated value of IS obtained through a mixed meal glucose tolerance test. Relevant controller parameters are updated to inform insulin dosing of IS. Performance of the HCL/FCL system with and without information of the changing IS was assessed using a novel performance metric penalizing the time outside the target glucose range.

resultsFeedback in AID systems provides a certain degree tolerance to changes in IS. However, IS-informed bolus and basal dosing improve glycemic outcomes, providing increased protection against hyperglycemia and hypoglycemia according to the individual's physiological state.

conclusionsThe proof-of-concept analysis presented here shows the potentially beneficial effects on system performance of informing the AID system with accurate estimates of IS. In particular, when considering reduced IS, the informed controller provides increased protection against hyperglycemia compared with the naïve controller. Similarly, reduced hypoglycemia is obtained for situations with increased IS. Further tailoring of the adaptation schemes proposed in this work is needed to overcome the increased hypoglycemia observed in the more resistant cases and to optimize the performance of the adaptation method.

Indexed as

Diabetes Mellitus, Type 1HyperglycemiaHypoglycemiaInsulin ResistanceAlgorithmsBlood GlucoseBlood Glucose Self-MonitoringGlucoseHumansHypoglycemic AgentsInsulinInsulin Infusion SystemsInsulin, Regular, HumanBlood GlucoseGlucoseHypoglycemic AgentsInsulinInsulin, Regular, Humanautomated insulin deliveryglucose managementinsulin sensitivitymodel predictive controltype 1 diabetes

Identifiers

PMID37864340
PMCPMC10658700
OpenAlexW4387840694

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.