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UBC Theses and Dissertations

Blood glucose regulation in type II diabetic patients Ekram, Fatemeh


Type II diabetes is the most pervasive diabetic disorder, characterized by insulin resistance, β-cell failure in secreting insulin and impaired regulatory effects of the liver on glucose concentration. Although in the initial steps of the disease, it can be controlled by lifestyle management, but most of the patients eventually require oral diabetic drugs and insulin therapy. The target for the blood glucose regulation is a certain range rather than a single value and even in this range, it is more desirable to keep the blood glucose close to the lower bound. Due to ethical issues and physiological restrictions, the number of experiments that can be performed on a real subject is limited. Mathematical modeling of glucose metabolism in the diabetic patient is a safe alternative to provide sufficient and reliable information on the medical status of the patient. In this thesis, dynamic model of type II diabetes has been expanded by incorporation of the pharmacokinetic-pharmacodynamic model of different types of insulin and oral drug to study the impact of several treatment regimens. The most efficient treatment has been then selected amongst all possible multiple daily injection regimens according to the patient's individualized response. In this thesis, the feedback control strategy is applied in this thesis to determine the proper insulin dosage continuously infused through insulin pump to regulate the blood glucose level. The logarithm of blood glucose concentration has been used as the controlled variable to reduce the nonlinearity of the glucose-insulin interactions. Also, the proportional-integral controller has been modified by scheduling gains calculated by a fuzzy inference system. Model predictive control strategy has been proposed in this research for the time that sufficient measurements of the blood glucose are available. Multiple linear models have been considered to address the nonlinearity of glucose homeostasis. On the other hand, the optimization objective function has been adjusted to better fulfill the objectives of the blood glucose regulation by considering asymmetric cost function and soft constraints. The optimization problem has been solved by the application of multi-parametric quadratic programming approach which reduces the on-line optimization problem to off-line function evaluation.

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