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Detection of a Meal Using Continuous Glucose Monitoring

Implications for an artificial β-cell

¹ Department of Chemical Engineering, University of California Santa Barbara, Santa Barbara, California
² Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute, Troy, New York
³ Stanford Medical Center, Stanford, California

Address correspondence and reprint requests to Francis J. Doyle III, Department of Chemical Engineering, University of California Santa Barbara, Santa Barbara, CA 93106-5080. E-mail: frank.doyle{at}icb.ucsb.edu

OBJECTIVE—The purpose of this study was to introduce a novel meal detection algorithm (MDA) to be used as part of an artificial β-cell that uses a continuous glucose monitor (CGM).

RESEARCH DESIGN AND METHODS—We developed our MDA on a dataset of 26 meal events using records from 19 children aged 1–6 years who used the MiniMed CGMS Gold. We then applied this algorithm to CGM records from a DirecNet pilot study of the FreeStyle Navigator continuous glucose sensor. During a research center admission, breakfast insulin was withheld for 1 h, and discrete glucose levels were obtained every 10 min after the meal.

RESULTS—Based on the Navigator readings, the MDA detected a meal at a mean time of 30 min from the onset of eating, at which time the mean serum glucose was 21 mg/dl above baseline (range 2–36 mg/dl), and >90% of meals were detected before the glucose had risen 40 mg/dl from baseline.

CONCLUSIONS—The MDA will enable automated insulin dosing in response to meals, facilitating the development of an artificial pancreas.

Abbreviations: CGM, continuous glucose monitor • CRC, clinical research center • ROC, rate of change

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