Background and Aims

An Artificial Pancreas usually involves subcutaneous (sc) devices to measure glucose and to infuse insulin with important delays. The intraperitoneal (ip) route is more physiological and would avoid the sc delays, improving glucose control[A]. In these last years, new ip devices have been designed[B] and new modalities of ip insulin delivery, e.g pulsatile, have been tested. The aim here is to present the new simulator and its first use in in silico trial comparing the ip vs. sc insulin delivery route.

[A]Dassau, E. et al. Diabetes,Obesity and Metabolism,19.12(2017):1698-1705.

[B]Iacovacci V. et al. Journal of Medical Devices,13.1(2019):011008.

Methods

The model of the UVA/Padova simulator has been modified to describe ip insulin administration. A Run-to-Run approach is used to adapt the Basal-Bolus Therapy (BBT) of the 100 in silico patients to the new ip site. A new version of the MPC controller [C] is synthesised using the new simulator and the optimized BBT.

[C] Soru P. et al. Annual Reviews in Control,36.1(2012):118-128.

Results

The intraperitoneal controller tested on a 2 days scenario maintains the glucose inside the target range for 93.5% of the time with no time spent below 70 mg/dl and 6.5% above 180 mg/dl. The MPC is able to keep the glycaemia inside the target range during all night.

Conclusions

The ip MPC results are much better than those obtained with the sc MPC. Future development of MPC involves the design of ad hoc constraints and safety. This new MPC in conjunctions with a new ip insulin pump will be tested in animals.