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DIAdvisor™-Personal mobile short-term blood glucose predictor and treatment advisor

Researchers: Marzia Cescon, Fredrik Ståhl, Meike Stemmann, Rolf Johansson, Dawn Tilbury

Project leader: Rolf Johansson

Partners:

   
Novo Nordisk A/S, Bagsværd, Denmark www.novonordisk.com Coordinator
Johannes Kepler University, Linz, Austria www.jku.at Control & advisory algorithms
Lunds University, Lund, Sweden www.lu.se Data based models
University of Padova, Padova, Italy www.unipd.it Physiological models and clinical trials
Centre Hospitalier Universitaire de Montpellier, Montpellier, France www.chu-montpellier.fr Clinical trials
Toumaz Technology Ltd, Abingdon, UK www.toumaz.com Device integration
Sensor Technology and Devices Ltd, Belfast, UK www.stnd.com Vital sign sensors
Ondalys, Montpellier, France www.ondalys.fr Non invasive glucose measurement
RomSoft, Iasi, Romania www.rms.ro Software
Institute for Clinical and Experimental Medicine , Prague, Czech Republic www.ikem.cz Clinical trials
RICAM, Linz, Austria www.ricam.oeaw.ac.at Mathematics
Ramboll, Virum, Denmark www.ramboll.com Risk management
Federation Internationale du Diabete Region Europe, Brussels, Belgium www.idf-europe.org Validation and Dissemination

 

Sponsoring Organization: the European Commision through the Information Society Technologies (IST) programme under the Seventh Framework Programme (FP7) n° 216592

Official Website: www.diadvisor.eu

Background:

Diabetes Mellitus is a chronic disease of disordered glucose metabolism due to defects in either insulin secretion from the pancreatic beta-cells or insulin action. Type-1 diabetes (T1DM), also called insulin-dependent diabetes mellitus (IDDM) is characterized by no production of insulin what so ever, whereas type-2 diabetes is caused by decreased sensitivity of the tissues to the metabolic effect of insulin. The basic effect of insulin lack or insulin resistance is to prevent the efficient uptake and utilization of glucose by most cells of the body,  resulting in abnormally high blood sugar levels (hyperglycemia). Sustained hyperglycemia is associated with acute ketoacidosis, nephropaty, rethinopaty,neuropathy and damages to the cardio-vascular system, therefore intensive insulin therapy aiming at near-normoglycemia(80-100 mg/dL) has been strongly promoted during the last decade, following the results of the major Diabetes Control and ComplicationsTrial (DCCT) and follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) studies. Focusing on tight blood glucose targets, the strategy comprises test of blood glucose levels at least four times a day, taking insulin at least three times a day by injections or using a pump and patient assistance by healthcare team through visits and phone calls. Meanwhile, the lack of improved quality of life and above all, the occurence of induced hypoglycemic events which may result in seizure, coma and eventually death preclude the feasibilityof such a DCCT-like intensive therapy.

The problem of maintaining glucose levels within a predefined range by acting on insulin delivery is a control poblem, whose controlled variable is glucose utilization, measured output is either the subcutaneous glucose provided by the CGMS or the capillary glucose provided by the fingerprick, control input is the insulin intake,  and the clinical criterion for success is plasma glucose. The system is subject to disturbances, the most important one being the meals. Control strategies involving the regulation of blood glucose levels in type 1 diabetes subjects range from classic PID feedback controller, run-to-run strategies to MPC algorithms.

The DIAdvisor™ project:


The DIAdvisor™is a large-scale integrating project (IP) aiming at the development of a prediction based tool which uses past and easily available information to optimise the therapy of type 1 and developed type 2 diabetes. The DIAdvisor™ is not dependent on specific sensor technologies and can be adapted to technologies like standard strip sensing, minimally-invasive continuous glucose sensors and emerging non-invasive methods.

For safety reason, the DIAdvisor™ system will be able to self-assess the confidence of its proposed decisions. For safety reasons as well as for the sake of therapy improvements, the system connects and provides information and trends to the Health Care Provider.

Glucose prediction is difficult and requires advanced science within the fields of physiological modelling, identification theory, control theory, medical device technology, risk management theory, sensor science and user understanding. It can be achieved only by a well balanced group of eminent experts, including academics, clinicians, user representatives and leading companies.

The expected impact of DIAdvisor™ will be improved diabetes control and quality of life in large populations of insulin treated patients, leading to fewer diabetic complications and lower Health Care costs. Moreover, the project will constitute a valuable opportunity for European companies to build up a special know-how leading to products that profoundly and positively have an impact on the lives of millions of people with other indications than diabetes.

Project coordinator

Jens Ulrik Poulsen
Novo Nordisk A/S
DK-3400 Hilleroed
Denmark

Phone: +45 4443 9692
http://www.novonordisk.com/

Press Releases and Articles

 

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