Optimization of insulin pump therapy based on high order run-to-run control scheme

•Two kinds of high order R2R control methods are presented to optimize the insulin pump therapy.•Using the proposed method, both the basal and the bolus insulin are adjusted simultaneously.•The proposed method can converge even when there are ±60 min random variations in meal timing or ±40% random variations in meal size.

Background and objectivesContinuous subcutaneous insulin infusion (CSII) pump is widely considered a convenience and promising way for type 1 diabetes mellitus (T1DM) subjects, who need exogenous insulin infusion. In the standard insulin pump therapy, there are two modes for insulin infusion: basal and bolus insulin. The basal-bolus therapy should be individualized and optimized in order to keep one subject's blood glucose (BG) level within the normal range; however, the optimization procedure is troublesome and it perturb the patients a lot. Therefore, an automatic adjustment method is needed to reduce the burden of the patients, and run-to-run (R2R) control algorithm can be used to handle this significant task.MethodsIn this study, two kinds of high order R2R control methods are presented to adjust the basal and bolus insulin simultaneously. For clarity, a second order R2R control algorithm is first derived and studied. Furthermore, considering the differences between weekdays and weekends, a seventh order R2R control algorithm is also proposed and tested.ResultsIn order to simulate real situation, the proposed method has been tested with uncertainties on measurement noise, drifts, meal size, meal time and snack. The proposed method can converge even when there are ±60 min random variations in meal timing or ±50% random variations in meal size.ConclusionsAccording to the robustness analysis, one can see that the proposed high order R2R has excellent robustness and could be a promising candidate to optimize insulin pump therapy.