Telemedical Artificial Pancreas
PARIS (Páncreas Artificial Telemédico Inteligente) research project
- Alberto de Leiva, PHD1,
- María Elena Hernando, PHD2 and
- on behalf of EDUAB-HSP and GBT-UPM
- 1EDUAB-HSP: Research Group, Department of Endocrinology, Diabetes and Nutrition, Universitat Autònoma de Barcelona–Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, and CIBER-BBN Networking Research Center, Saragossa, Spain;
- 2GBT-UPM: Research Group, Bioengineering and Telemedicine, Polytechnic University Madrid, and CIBER-BBN Networking Research Center, Madrid, Spain.
- Corresponding author: Alberto de Leiva, aleiva{at}santpau.cat.
DEBATE
The integration of continuous subcutaneous insulin infusion (CSII) (insulin pump therapy) and continuous interstitial glucose monitoring (CGM) appears to be an excellent solution for obtaining the desirable metabolic control for most insulin-treated subjects (1–4). Several studies have suggested that CGM with readings in real-time (CGM-RT) further improves blood glucose control (5–9). The introduction of CGM and CSII into clinical practice has generated an inevitable increase in the amount of data to be managed and interpreted. Telemedicine facilitates data management and preprocessing to optimize therapy. Among other potential benefits, telemedicine improves communication among patients and health care providers, improves quantity and quality of data collection, and eases decision-making and therapy adjustment (10–12). DIABTel, a web-based telemedicine system, is a good example for a solution designed to supply these needs (13).
PARIS (Páncreas Artificial Telemédico Inteligente) is a coordinated research project to develop and validate a telemedical artificial pancreas (TAP), a multi-access telemedicine system that integrates CGM-RT, insulin pump, a smart assistant (SA), and close-loop control algorithms. SA is a personal intelligent assistant based on a handheld digital device to provide both personal and remote loop strategies, using CGM, CSII, and mobile general packet radio service (GPRS) communication with a telemedicine central server (TMCS).
This review summarizes acquired experiences with TAP, integrating these new technologies with the objective to improve glycemic control of type 1 diabetic patients.
RESEARCH DESIGN AND METHODS
Description of the DIABTel telemedicine system
The telemedicine architecture consists of two components: the medical unit (a telemedical central server) and the patient unit (a smart assistant).
The TMCS at the diabetes center of the hospital continuously runs, receiving and processing patients' monitoring data, messages, and requests for professional advice. A previous publication already reported the benefits of DIABTel, allowing the implementation of an easy-to-use, user-tailored telemedicine system with a technological platform allowing tight …
