ABSTRACT
Artificial pancreas (AP) control systems aim to achieve automated regulation of blood glucose concentration in people with type 1 diabetes (T1D). While in open-loop insulin administration, the individual, with physician supervision, makes all the decisions regarding the insulin adjustments. AP is a closed-loop system that automatically manipulates the insulin doses and infusion [1–6]. An AP system consists of a minimum of four components: (1) a person with T1D, (2) a continuous glucose monitor (CGM) that measures and reports the interstitial glucose concentration, (3) a control algorithm that makes decisions regarding the insulin infusion rate, and (4) an insulin pump that administers the insulin to the patient. The AP may utilize additional measuring devices in order to feed more comprehensive information to the controller about the subject’s physiological condition [7]. The physiological conditions, such as physical activity or exercise, stress, and sleep, are assessed by the interpretation of physiological variables reported by wearable devices, such as heart rate, energy expenditure, etc. [8–10]. Using the measured physiological variables in addition to CGM data enables a multivariable AP with a controller to manage the effect of otherwise unknown (unannounced) disturbances [11]. In a fully automated AP (no manual entries), while the measured physiological variables relieve the need for manual entries about the physiological conditions, integration of meal detection and meal size estimation components into AP systems is needed to compensate for meal announcements.
