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M Massi Benedetti

Publications and source records attributed to M Massi Benedetti.

4 recordsLinked to original sources

Time delay compensation for closed-loop insulin delivery systems: a simulation study.

Closed loop insulin therapy certainly represents the best possible approach to insulin replacement. However, present limitations preclude wider application of the so-called artificial pancreas. Therefore, a thorough understanding of these limitations is needed to design better systems for future long-term use. The present simulation study was design: to obtain better information on the impact of the measurement delay of currently available closed-loop devices both during closed-loop insulin delivery and blood glucose clamp studies, and to design and test a time delay compensator based on the method originally described by O.J. Smith. Simulations were performed on a Compaq Deskpro 486/25 personal computer under MS-DOS operating system using Simnon rel. 3.00 software. There was a direct relationship between measurement delay and amount of insulin delivered, i.e., the longer the delay the higher the insulin dose needed to control a rise in blood glucose; the closed-loop response in presence of a time delay was qualitatively impaired both during insulin delivery and blood glucose clamp studies; time delay compensation was effective in reducing the insulin dose and improving controller stability during the early phase of clamp studies. However, the robustness of a Smith's predictor-based controller should be carefully evaluated before implementation in closed-loop systems can be considered.

Computer Simulation

Wearable system for acquisition, processing and storage of the signal from amperometric glucose sensors.

A wearable device for the acquisition, processing and storage of the signal from needle-type glucose sensors has been designed and developed as part of a project aimed at developing a portable artificial pancreas. The device is essential to assess the operational characteristics of miniaturized sensors in vivo. It can be connected to sensors operating at a constant potential of 0.65 Volts, and generating currents in the order of 10(-9) Amp. It is screened and equipped with filters that permit data recording and processing even in the presence of electrical noise. It can operate with sensors with different characteristics (1-200 nA full scale). The device has been designed to be worn by patients, so its weight and size have been kept to a minimum (250 g; 8.5 x 14.5 x 3.5 cm). It is powered by rechargeable Ni/Cd batteries allowing continuous operation for 72 h. The electronics consists of an analog card with operational amplifiers, and a digital one with a microprocessor (Intel 80C196, MCS-96 class, with internal 16-bit CPU supporting programs written in either C or Assembler language), a 32 Kb EPROM, and an 8 Kb RAM where the data are stored. The microprocessor can run either at 5 or 10 Mhz and features on-chip peripherals: an analog/digital (A/D) converter, a serial port (used to transfer data to a Personal Computer at the end of the 72 h), input-output (I/O) units at high-speed, and two timers. The device is programmed and prepared to operate by means of a second hand-held unit equipped with an LCD display and a 16-key numeric pad.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose Self-Monitoring

Hormonal and metabolic responses in brittle diabetic patients during feedback intravenous insulin infusion.

Twenty-four hour profiles of blood hormones and intermediary metabolites were obtained in seven 'brittle' diabetic subjects during their usual insulin therapy and during feedback intravenous insulin infusion from an artificial pancreas (GCIIS). The results were compared to those in matched stable diabetics and normal controls. Although routine insulin doses were higher in the brittle group than in the stable group (164 +/- 32 (mean +/- SE) vs. 58 +/- 8 U/day, P less than 0.005) during routine therapy, plasma free insulin levels were equal (35 +/- 12 vs. 31 +/- 6 mU/l). In the brittle group feedback i.v. insulin infusion reduced daily requirements to normal levels (80 +/- 13 U/day, P less than 0.025; stable group 71 +/- 4 U/day, NS). On routine therapy blood glucose levels were not different in the two groups (brittle 10.5 +/- 1.6, stable 10.8 +/- 0.6 mmol/l) and were similarly corrected by the GCIIS (6.9 +/- 0.3 and 6.9 +/- 0.3 mmol/l, respectively). Blood lactate and pyruvate levels were markedly abnormal in the brittle group during routine therapy (lactate: brittle group 1.93 +/- 0.27 mmol/l, stable group 0.91 +/- 0.07 mmol/l, P less than 0.025), and this abnormality was not corrected by the GCIIS (1.75 +/- 0.32 and 0.88 +/- 0.08 mmol/l, P less than 0.005). Abnormalities were also found in profiles of blood alanine and glycerol, and serum cortisol. Blood ketone body levels did not differ between the two groups of patients. The results suggest a defect in insulin delivery from subcutaneous tissue into the plasma. These patients have a characteristic metabolic abnormality, unresponsive to short-term normoglycaemia, either as the result of long-term disturbance of diabetic control, or as a marker for the underlying hormonal or biochemical abnormality.

3-Hydroxybutyric Acid