Artículos de publicaciones periódicas

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Browsing Artículos de publicaciones periódicas by Subject "CONTROL EN MODO DESLIZANTE"

Now showing 1 - 3 of 3
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    Artificial pancreas: clinical study in Latin America without premeal insulin boluses
    (2018-09) Sánchez-Peña, Ricardo; Colmegna, Patricio; Garelli, Fabricio; De Battista, Hernán; García Violini, Demián; Moscoso-Vásquez, Marcela; Rosales, Nicolás; Fushimi, Emilia; Campos-Náñez, Enrique; Breton, Marc; Beruto, Valeria; Scibona, Paula; Rodriguez, Cintia; Giunta, Javier; Simonovich, Ventura; Belloso, Waldo H.; Cherñavvsky, Daniel; Grosembacher, Luis
    "Background: Emerging therapies such as closed-loop (CL) glucose control, also known as artificial pancreas (AP) systems, have shown significant improvement in type 1 diabetes mellitus (T1DM) management. However, demanding patient intervention is still required, particularly at meal times. To reduce treatment burden, the automatic regulation of glucose (ARG) algorithm mitigates postprandial glucose excursions without feedforward insulin boluses. This work assesses feasibility of this new strategy in a clinical trial. Methods: A 36-hour pilot study was performed on five T1DM subjects to validate the ARG algorithm. Subjects wore a subcutaneous continuous glucose monitor (CGM) and an insulin pump. Insulin delivery was solely commanded by the ARG algorithm, without premeal insulin boluses. This was the first clinical trial in Latin America to validate an AP controller. Results: For the total 36-hour period, results were as follows: average time of CGM readings in range 70-250 mg/dl: 88.6%, in range 70-180 mg/dl: 74.7%, <70 mg/dl: 5.8%, and <50 mg/dl: 0.8%. Results improved analyzing the final 15-hour period of this trial. In that case, the time spent in range was 70-250 mg/dl: 94.7%, in range 70-180 mg/dl: 82.6%, <70 mg/dl: 4.1%, and <50 mg/dl: 0.2%. During the last night the time spent in range was 70-250 mg/dl: 95%, in range 70-180 mg/dl: 87.7%, <70 mg/dl: 5.0%, and <50 mg/dl: 0.0%. No severe hypoglycemia occurred. No serious adverse events were reported. Conclusions: The ARG algorithm was successfully validated in a pilot clinical trial, encouraging further tests with a larger number of patients and in outpatient settings."
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    Automatic regulatory control in type 1 diabetes without carbohydrate counting
    (2018-05) Colmegna, Patricio; Garelli, Fabricio; De Battista, Hernán; Sánchez-Peña, Ricardo
    "A new approach to automatically regulate the glucose level in type 1 diabetes is presented in this work. This is the so-called Automatic Regulation of Glucose (ARG) algorithm, which is based on a switched Linear Quadratic Gaussian (LQG) inner controller, combined with an outer sliding mode safety loop with Insulin on Board (IOB) constraints. In silico and in vivo results without feedforward insulin boluses delivered at meal times indicate that safe blood glucose control can be achieved by the proposed controller. This controller is simple to migrate to well-known hardware platforms, and intuitive to tune using a priori clinical information."
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    Control no-híbrido de glucemia ensayado en pacientes ambulatorios con Diabetes Tipo 1
    (2022-07) Garelli, Fabricio; Fushimi, Emilia; Rosales, Nicolás; Arambarri, Delfina; Serafini, María Cecilia; De Battista, Hernán; Grosembacher, Luis; Sánchez-Peña, Ricardo
    "En este trabajo se presenta la experiencia argentina en el problema de regulación de los niveles de glucosa en sangre para pacientes con Diabetes Mellitus Tipo 1 (insulino-dependientes), denominado Páncreas Artificial. El grupo de trabajo ha realizado 3 pruebas clínicas, las primeras en Latinoamérica. Las dos primeras fueron concretadas en 2016 y 2017, ambas en el Hospital Italiano de Buenos Aires (HIBA) con 5 pacientes adultos durante 36 hs. En la segunda de ellas se utilizó un nuevo algoritmo de control de lazo cerrado puro (sin bolo prandial), llamado ARG (Automatic Regulation of Glucose) y basado en un control LQG conmutado en combinación con una capa de seguridad llamada SAFE (Safety Auxiliary Feedback Element). Más recientemente y en plena pandemia de COVID-19 se llevó a cabo la primera prueba ambulatoria, realizada en 2021 en un hotel con 5 pacientes durante 6 días. En esta tercera prueba además, se utilizó una plataforma desarrollada por la Universidad Nacional de La Plata (UNLP), denominada InsuMate. Ésta conecta el celular con la bomba de insulina y el monitor de glucosa, aloja el algoritmo de control y permite el monitoreo remoto de múltiples pacientes. Los resultados obtenidos sugieren que el uso del algoritmo ARG en forma ambulatoria es factible, seguro y eficaz en comparación con la terapia usual. Asimismo, la plataforma InsuMate resultó ser intuitiva y sencilla para los usuarios, tanto médicos como pacientes participantes del ensayo, logrando un tiempo de funcionamiento del lazo cerrado superior al 95 %."