María Elena Hernando Pérez

The INCA System: A Further Step Towards a Telemedical Artificial Pancreas

Biomedical engineering research efforts have accomplished another level of a ldquotechnological solutionrdquo for diabetes: an artificial pancreas to be used by patients and supervised by healthcare professionals at any time and place. Reliability of continuous glucose monitoring, availability of real-time programmable insulin pumps, and validation of safe and efficient control algorithms are critical components for achieving that goal. Nevertheless, the development and integration of these new technologies within a telemedicine system can be the basis of a future artificial pancreas. This paper introduces the concept, design, and evaluation of the ldquointelligent control assistant for diabetes, INCArdquo system. INCA is a personal digital assistant (PDA)-based personal smart assistant to provide patients with closed-loop control strategies (personal and remote loop), based on a real-time continuous glucose sensor (Guardian RT, Medtronic), an insulin pump (D-TRON, Disetronic Medical Systems), and a mobile general packet radio service (GPRS)-based telemedicine communication system. Patient therapeutic decision making is supervised by doctors through a multiaccess telemedicine central server that provides to diabetics and doctors a Web-based access to continuous glucose monitoring and insulin infusion data. The INCA system has been technically and clinically evaluated in two randomized and crossover clinical trials showing an improvement on glycaemic control of diabetic patients.

Agent-Based Model of the Endocrine Pancreas and Interaction with Innate Immune System

In the present work we have developed an agent-based model of the interaction between the beta cells of the endocrine pancreas and the macrophages of the innate immune system in a mouse. The aim is to simulate the processes of proliferation and apoptosis of the beta cells and the phagocytosis of cell debris by macrophages. We have used data from the literature to make the model architecture and to define and set up the input variables. This model obtains good approximations to the real processes modeled and could be used to shed light on some open questions about phagocytosis, wave of apoptosis in the young mice, growing of the beta cell mass and processes that could induce the immune response against beta cells related to type 1 diabetes.