Evaluation of blood glucose level control in type 1 diabetic patients using deep reinforcement learning

PLoS One. 2022 Sep 13;17(9):e0274608. doi: 10.1371/journal.pone.0274608. eCollection 2022.

Abstract

Diabetes mellitus is a disease associated with abnormally high levels of blood glucose due to a lack of insulin. Combining an insulin pump and continuous glucose monitor with a control algorithm to deliver insulin is an alternative to patient self-management of insulin doses to control blood glucose levels in diabetes mellitus patients. In this work, we propose a closed-loop control for blood glucose levels based on deep reinforcement learning. We describe the initial evaluation of several alternatives conducted on a realistic simulator of the glucoregulatory system and propose a particular implementation strategy based on reducing the frequency of the observations and rewards passed to the agent, and using a simple reward function. We train agents with that strategy for three groups of patient classes, evaluate and compare it with alternative control baselines. Our results show that our method is able to outperform baselines as well as similar recent proposals, by achieving longer periods of safe glycemic state and low risk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose*
  • Diabetes Mellitus, Type 1* / drug therapy
  • Glycemic Control
  • Humans
  • Insulin / therapeutic use
  • Insulin Infusion Systems
  • Insulin, Regular, Human / therapeutic use

Substances

  • Blood Glucose
  • Insulin
  • Insulin, Regular, Human

Grants and funding

This work was supported in part by the grants PID2020-112675RBC41 (ONOFRE-3) funded by MCIN/AEI/10.13039/501100011033, TEC2017-84423-C3-2-P (ONOFRE-2) funded by AEI/FEDER/UE [Agencia Estatal de Investigación (AEI), Fondo Europeo de Desarrollo Regional (FEDER), and Unión Europea (UE)], and RYC-2017-23823 funded by MCIN/AEI /10.13039/501100011033 and by “ESF Investing in your future”. The work of Phuwadol Viroonluecha was supported by the AEI Formación de Personal Investigador (FPI) Predoctoral Grant PRE2018-084260. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.