Effectiveness of Intravenous Infusion Algorithms for Glucose Control in Diabetic Patients Using Different Simulation Models

The effectiveness of closed-loop insulin infusion algorithms is assessed for three different mathematical models describing insulin and glucose dynamics within a Type I diabetes patient. Simulations are performed to assess the effectiveness of proportional plus integral plus derivative (PID) control, feedforward control, and a physiologically-based control system with respect to maintaining normal glucose levels during a meal and during exercise. Control effectiveness is assessed by comparing the simulated response to a simulation of a healthy patient during both a meal and exercise and establishing maximum and minimum glucose levels and insulin infusion levels, as well as maximum duration of hyperglycemia. Controller effectiveness is assessed within the minimal model, the Sorensen model, and the Hovorka model. Results showed that no type of control was able to maintain normal conditions when simulations were performed using the minimal model. For both the Sorensen model and the Hovorka model, proportional control was sufficient to maintain normal glucose levels. Given published clinical data showing the ineffectiveness of PID control in patients, the work demonstrates that controller success based on simulation results can be misleading, and that future work should focus on addressing the model discrepancies.