1. A strategy based on integer programming for optimal dosing and timing of preventive hypoglycemic treatments in type 1 diabetes management.
- Author
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Pavan J, Noaro G, Facchinetti A, Salvagnin D, Sparacino G, and Del Favero S
- Subjects
- Humans, Computer Simulation, Blood Glucose analysis, Diabetes Mellitus, Type 1 drug therapy, Algorithms, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents therapeutic use, Hypoglycemia prevention & control
- Abstract
Background and Objectives: One of the major problems related to type 1 diabetes (T1D) management is hypoglycemia, a condition characterized by low blood glucose levels and responsible for reduced quality of life and increased mortality. Fast-acting carbohydrates, also known as hypoglycemic treatments (HT), can counteract this event. In the literature, dosage and timing of HT are usually based on heuristic rules. In the present work, we propose an algorithm for mitigating hypoglycemia by suggesting preventive HT consumption, with dosages and timing determined by solving an optimization problem., Methods: By leveraging integer programming and linear inequality constraints, the algorithm can bind the amount of suggested carbohydrates to standardized quantities (i.e., those available in "off-the-shelf" HT) and the minimal distance between consecutive suggestions (to reduce the nuisance for patients)., Results: The proposed method was tested in silico and compared with competitor algorithms using the UVa/Padova T1D simulator. At the cost of a slight increase of HT consumed per day, the proposed algorithm produces the lowest median and interquartile range of the time spent in hypoglycemia, with a statistically significant improvement over most competitor algorithms. Also, the average number of hypoglycemic events per day is reduced to 0 in median., Conclusions: Thanks to its positive performances and reduced computational burden, the proposed algorithm could be a candidate tool for integration in a DSS aimed at improving T1D management., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The research presented in this work was supported by Dexcom Inc., San Diego, CA. The authors hold a patent application on the technology presented in this work., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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