A Web-Based Educational Simulation

Package for Glucose-Insulin Levels in

the Human Body

Warning:
"The simulator does not differentiate betw
their sex, age, race, or BMI (body mass in
represents an average person. Also, Gluc
account intra- and inter-personal variation
used for making medical decisions."
The GlucoSim should only be used for

CONTROLLER MODES:
1. Constant Injection Rate:

This mode simulates the case where there is constant injection of insulin.
The infusion site for the insulin pump is based on the option selected from the graphical user
interface while the insulin injections (insulin dose) are subcutaneous injections.
If subcutaneous infusion is selected for constant rate injection, entering bolus dose values as
insulin dose in graphical user interface can simulate use of current commercial pumps.

2. Proportional Integral Derivative (PID) Control :

The PID control algorithm is as follows:

where

For this case, e(t), the error is the deviation of measured blood glucose concentration from
the set point (the optimal value of 80 mg/dl). p(t) is the output of the controller (controlled
variable, insulin injection rate).
The controller takes action based on the deviation of blood glucose concentration from the
optimum value. The first term in the brackets is the proportional term which takes the current
value of the error into account. It provides a rapid adjustment of manipulated variable and
speeds the dynamic response. The second term (integral term) sums up the past error values

and basically takes the history of the system into account therefore can eliminate steady state
error in the case of set point change or persistent disturbance. The last term (derivative term)
has predictive effect and it takes the future state of the system into account.
Tuning Parameters:

(integral time), D (derivative time) determines the relative weight of the three terms where
the weight of proportional term is 1. Increasing D (derivative time) will increase the weight
of derivative term , while increasing (integral time) will decrease the weight of integral
term.
KC is the gain of the controller. The negative value is due to the fact that increasing injection
rate will decrease the blood glucose concentration. Increasing the magnitude of KC will result
in a more aggressive controller which will inject more insulin at the same conditions.
Anti-reset windup: It is common practice to have settings that prevent the buildup of integral
(reset) term. In this case, (when enabled) the settings put a maximum value to the magnitude
of the integral term and the integral term is reduced to a value when the both error and
integral have the same sign.

3. Internal Model Control (IMC):

The IMC diagram is as follows:

TF: Transfer function

Unlike PID control, IMC algorithm utilizes a built-in internal model to compute the output
(injection rate) from the feedback (blood insulin concentration). In the generation of IMC
algorithm, the invertable part of the process model is inverted (in Laplace domain) and a
filter is added to the algorithm if necessary. For this case the model is a simple version of the
actual model. (First order plus time delay). The filter is a first order filter with f (filter time
constant).
Tuning Parameters:
Filter time constant f : It is the desired closed-loop time constant. Decreasing f will cause the
controller to become more agressive.
Model parameters: They are the parameters of the internal model. Normally they should be
set to the default values by clicking "Set to default model parameters". Hovewer a first order
plus time delay model may not be able to predict the actual model accurately at every
condition (the default values are determined from the response of blood glucose
concentration to a step input of 2mU/min) so the parameters can be a part of the tuning.

4. Model Predictive Control (MPC):

MPC is a model-based control algorithm more sophisticated than Internal Model Control
(IMC). Two main components of MPC are:
- Controller
- Estimator
The estimator (for this case: Linear Kalman filter) has an internal model of the process
(linear 33th order) and it estimates the each state of the system (e.g. glucose amount in
stomach, insulin concentration in the interstitial fluid) using the limited feedback from the
system (blood glucose concentration) in the presence of measurement noise. It estimates the
states at each sampling time (measurement time).
The controller has an internal model of the process (for this case linearized version of the
actual model, 33th order) and at each sampling time it computes future insulin injection rates
that will minimize the predicted values of the deviation of blood glucose levels from the
optimum value (set point, reference point, 80 mg/dl). Basically it solves the following
optimization problem:

p: prediction horizon
m: control horizon
u: insulin injection rate (mU/min) u: change in injection rate 0 < u < 100 mU/min
y: estimates of future glucose level measurements
y: Weight for deviation of predicted glucose concentration from set point
u: Weight for change in injection rate
r: 80 mg/dl reference (set point)
Controller receives the initial values for the optimization problem (current states of the
system) from the estimator. The controller solves the optimization problem at each sampling
time with the updated states from the estimator.
Tuning Parameters:
Weight for set point tracking penalty y and weight for input move penalty u : Here an
increased u causes the injection rate to change more smoothly as it penalizes the change in
injection rate more in the objective function. Thus a larger ratio of y to u makes the
controller more aggressive while a small ratio makes it less aggressive.
Prediction and control horizon: The larger the horizons, the further time the controller takes
into account in the optimization problem. One disadvantage of having large horizons is the
large amount of time that it takes to solve the optimization problem. The control horizon
should be less than or equal to prediction horizon.

Insulin Route:

The infusion site for the insulin pump is based on the option selected from the graphical user

interface while the insulin injections (insulin dose) are subcutaneous injections.

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