Med Biol Eng Comput DOI 10.1007/s11517-014-1231-1
SPECIAL ISSUE - ORIGINAL ARTICLE
Designing an artificial pancreas architecture: the AP@home experience Giordano Lanzola · Chiara Toffanin · Federico Di Palma · Simone Del Favero · Lalo Magni · Riccardo Bellazzi
Received: 31 March 2014 / Accepted: 16 November 2014 © International Federation for Medical and Biological Engineering 2014
Abstract The latest achievements in sensor technologies for blood glucose level monitoring, pump miniaturization for insulin delivery, and the availability of portable computing devices are paving the way toward the artificial pancreas as a treatment for diabetes patients. This device encompasses a controller unit that oversees the administration of insulin micro-boluses and continuously drives the pump based on blood glucose readings acquired in real time. In order to foster the research on the artificial pancreas and prepare for its adoption as a therapy, the European Union in 2010 funded the AP@home project, following a series of efforts already ongoing in the USA. This paper, authored by members of the AP@home consortium, reports on the technical issues concerning the design and implementation of an architecture supporting the exploitation of an artificial pancreas platform. First a PC-based platform was developed by the authors to prove the effectiveness and reliability of the algorithms responsible for insulin administration. A mobile-based one was then adopted to improve the comfort for the patients. Both
On behalf of the AP@home consortium. G. Lanzola (*) · R. Bellazzi Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Via Ferrata 1, 27100 Pavia, Italy e-mail: [email protected] C. Toffanin · F. Di Palma · L. Magni Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy S. Del Favero Department of Information Engineering, University of Padova, Padova, Italy
platforms were tested on real patients, and a description of the goals, the achievements, and the major shortcomings that emerged during those trials is also reported in the paper. Keywords Artificial pancreas · Glucose control algorithms · Remote monitoring · Diabetes mellitus type 1 · e-Health and m-health for diabetes management
1 Key terms • Artificial pancreas: a closed-loop control system currently being researched for diabetes patients, which tries to emulate the behavior of a healthy pancreas. This encompasses the continuous delivery of insulin in order to control the blood glucose level based on its real-time monitoring. • Artificial pancreas platform: refers to the technology concerning a specific artificial pancreas implementation. This is given by the combination of the hardware components (i.e., the computing device, the blood glucose sensor, and the insulin pump) together with the software algorithm able to compute in real time the amount of insulin required and actually administer it to the patient. • Artificial pancreas architecture: throughout the paper, this term is used to refer to the broadest set of components supporting the use of the artificial pancreas. Those include the blood glucose sensor and the insulin pump, the regulation algorithm and the computing device for running it, and the remote data acquisition service and the application enabling patient monitoring through the web. The architecture specifies the roles of the components and the way in which they exchange information among each other.
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2 Introduction Diabetes Mellitus (T1DM) is a chronic disease characterized by the failure of pancreas beta cells to produce insulin which results in elevated blood glucose levels (BGL). The so-called hyperglycemia (i.e., BGL > 180 mg/dl) decreases both the quality of life and its expectancy, so it should be avoided. In order to control the BGL, diabetes patients have to be treated via exogenous insulin administration. If too much insulin is injected, BGL drops too low causing hypoglycemia (i.e., BGL
SPECIAL ISSUE - ORIGINAL ARTICLE
Designing an artificial pancreas architecture: the AP@home experience Giordano Lanzola · Chiara Toffanin · Federico Di Palma · Simone Del Favero · Lalo Magni · Riccardo Bellazzi
Received: 31 March 2014 / Accepted: 16 November 2014 © International Federation for Medical and Biological Engineering 2014
Abstract The latest achievements in sensor technologies for blood glucose level monitoring, pump miniaturization for insulin delivery, and the availability of portable computing devices are paving the way toward the artificial pancreas as a treatment for diabetes patients. This device encompasses a controller unit that oversees the administration of insulin micro-boluses and continuously drives the pump based on blood glucose readings acquired in real time. In order to foster the research on the artificial pancreas and prepare for its adoption as a therapy, the European Union in 2010 funded the AP@home project, following a series of efforts already ongoing in the USA. This paper, authored by members of the AP@home consortium, reports on the technical issues concerning the design and implementation of an architecture supporting the exploitation of an artificial pancreas platform. First a PC-based platform was developed by the authors to prove the effectiveness and reliability of the algorithms responsible for insulin administration. A mobile-based one was then adopted to improve the comfort for the patients. Both
On behalf of the AP@home consortium. G. Lanzola (*) · R. Bellazzi Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Via Ferrata 1, 27100 Pavia, Italy e-mail: [email protected] C. Toffanin · F. Di Palma · L. Magni Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy S. Del Favero Department of Information Engineering, University of Padova, Padova, Italy
platforms were tested on real patients, and a description of the goals, the achievements, and the major shortcomings that emerged during those trials is also reported in the paper. Keywords Artificial pancreas · Glucose control algorithms · Remote monitoring · Diabetes mellitus type 1 · e-Health and m-health for diabetes management
1 Key terms • Artificial pancreas: a closed-loop control system currently being researched for diabetes patients, which tries to emulate the behavior of a healthy pancreas. This encompasses the continuous delivery of insulin in order to control the blood glucose level based on its real-time monitoring. • Artificial pancreas platform: refers to the technology concerning a specific artificial pancreas implementation. This is given by the combination of the hardware components (i.e., the computing device, the blood glucose sensor, and the insulin pump) together with the software algorithm able to compute in real time the amount of insulin required and actually administer it to the patient. • Artificial pancreas architecture: throughout the paper, this term is used to refer to the broadest set of components supporting the use of the artificial pancreas. Those include the blood glucose sensor and the insulin pump, the regulation algorithm and the computing device for running it, and the remote data acquisition service and the application enabling patient monitoring through the web. The architecture specifies the roles of the components and the way in which they exchange information among each other.
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2 Introduction Diabetes Mellitus (T1DM) is a chronic disease characterized by the failure of pancreas beta cells to produce insulin which results in elevated blood glucose levels (BGL). The so-called hyperglycemia (i.e., BGL > 180 mg/dl) decreases both the quality of life and its expectancy, so it should be avoided. In order to control the BGL, diabetes patients have to be treated via exogenous insulin administration. If too much insulin is injected, BGL drops too low causing hypoglycemia (i.e., BGL
