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Background: Most closed-loop insulin delivery systems rely on model-based controllers to control the blood glucose (BG) level. Simple models of glucose metabolism, which allow easy design of the control law, are limited in their parametric identification from raw data. New control models and controllers issued from them are needed.
Methods: A proportional integral derivative with double phase lead controller was proposed. Its design was based on a linearization of a new nonlinear control model of the glucose-insulin system in type 1 diabetes mellitus (T1DM) patients validated with the University of Virginia/Padova T1DM metabolic simulator. A 36 h scenario, including six unannounced meals, was tested in nine virtual adults. A previous trial database has been used to compare the performance of our controller with their previous results. The scenario was repeated 25 times for each adult in order to take continuous glucose monitoring noise into account. The primary outcome was the time BG levels were in target (70-180 mg/dl).
Results: Blood glucose values were in the target range for 77% of the time and below 50 mg/dl and above 250 mg/dl for 0.8% and 0.3% of the time, respectively. The low blood glucose index and high blood glucose index were 1.65 and 3.33, respectively.
Conclusion: The linear controller presented, based on the linearization of a new easily identifiable nonlinear model, achieves good glucose control with low exposure to hypoglycemia and hyperglycemia.
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http://dx.doi.org/10.1177/193229681300700315 | DOI Listing |
Curr Med Res Opin
September 2025
Department of Internal Medicine, Taksim Training and Research Hospital, Istanbul, Turkey.
Introduction: Diabetes Mellitus is a chronic disease characterised by elevated plasma glucose (PG) levels. HbA1c has been widely utilized for diabetes diagnosis. However, certain conditions restrict its use.
View Article and Find Full Text PDFManaging diabetes in older adults requires balancing long-term glycaemic control with the prevention of hypoglycaemia, to which this population is particularly vulnerable owing to frailty, multimorbidity and cognitive decline. Guidelines recommend individualized glucose targets for older adults, particularly those with multimorbidity or increased hypoglycaemia risk. For individuals with frailty or cognitive impairment, relaxed HbA1c targets are often appropriate to reduce the risk of adverse events.
View Article and Find Full Text PDFBiomed Environ Sci
August 2025
Clinical Research Institute, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
Objective: To investigate the association between long-term glycemic control and cerebral infarction risk in patients with diabetes through a large-scale cohort study.
Methods: This prospective, community-based cohort study included 12,054 patients with diabetes. From 2006 to 2012, 38,272 fasting blood glucose (FBG) measurements were obtained from these participants.
Int J Mol Med
November 2025
Department of Neurosciences 'Rita Levi Montalcini', University of Turin, I‑10125 Turin, Italy.
Kinases are activators of well‑known inflammatory cascades implicated in metabolic disorders, and abnormal activation of casein kinase II (CK2) is associated with several inflammatory disorders. However, thus far, its role in the low‑grade chronic inflammatory response known as 'metaflammation', which is a hallmark of obesity and type 2 diabetes, has not yet been elucidated. The present study aimed to evaluate the role of CK2 in diet‑induced metaflammation and the effects of the CK2 inhibitor 4,5,6,7‑tetrabromobenzotriazole (TBB) on a murine model fed a high‑fat‑high‑sugar (HFHS) diet.
View Article and Find Full Text PDFJ Eval Clin Pract
September 2025
Health Technology Assessment Unit, Acute and Hospital-Based Care Portfolio, Ontario Health, Toronto, Ontario, Canada.
Rationale: Systematic reviews are essential for evidence-based healthcare decision-making. While it is relatively straightforward to quantitatively assess random errors in systematic reviews, as these are typically reported in primary studies, the assessment of biases often remains narrative. Primary studies seldom provide quantitative estimates of biases and their uncertainties, resulting in systematic reviews rarely including such measurements.
View Article and Find Full Text PDF