Initial titration for people with type 1 diabetes using an artificial pancreas

Abstract

For people with type 1 diabetes and some with type 2 diabetes, the problem of insulin titration, i.e. finding an adequate basal rate of insulin, is a complex and time-consuming task. This paper proposes a simple model-free algorithm and a procedure for fast initial titration in people with type 1 diabetes (T1D). A modified proportional-integral-derivative (PID) controller (i) updates the estimated insulin basal rate, and (ii) administers micro-boli of insulin every 5 minutes using glucose measurements from a continuous glucose monitor (CGM). A bolus calculator mitigates the effect of meals and reduces postprandial peaks. We evaluate the performance of our system qualitatively and numerically using a virtual clinic of 1,000 T1D patients with a broad inter-patient variability representative of a real population of people with T1D. We let the titration phase run for three consecutive days, followed by a three-day test phase using the newly computed basal insulin infusion rate. The proposed algorithm is able to provide a safe titration and individualized treatment for people with T1D.