A new technology developed by the University of Virginia has improved type 1 diabetes control by allowing an artificial pancreas system to adapt to users’ changing bodies. The system, known as Adaptive Biobehavioral Control (ABC), adjusts the automated insulin delivery system every two weeks and gives users access to a “digital twin” simulation for testing different strategies to manage their blood sugar.
A six-month study found that users of the ABC technology increased the time spent in a safe blood-sugar range from 72% to 77% and reduced their hemoglobin A1c from 6.8% to 6.6%. Unlike traditional artificial pancreas systems, which require manual adjustments to account for changing insulin needs, the ABC system maps each user to their digital twin in the cloud. This allows people to experiment with their own data in a safe, simulated environment before making any changes to their system.
Boris Kovatchev, PhD, Director of the UVA Center for Diabetes Technology, noted that the technology helps address two challenges. First, it improves blood-sugar control during the day, when factors like meals and exercise cause fluctuations. Second, it helps users overcome a plateau in time spent within a safe blood-sugar range, which typically peaks at 70-75% as users struggle to adapt to how their system works.
The ABC technology uses digital twins, which are computer simulations that replicate users’ metabolic systems. This allows the artificial pancreas to adjust to users’ evolving needs and gives them an interactive platform to test different system settings, such as altering insulin release levels during the night.
Kovatchev explained that the success of the system relies on “human-machine co-adaptation,” where both the artificial pancreas algorithm and the user make treatment decisions. He emphasized that digital twin technology is crucial for facilitating this collaboration.
The study’s results were published in npj Digital Medicine, and the research team included Kovatchev, Patricio Colmegna, Jacopo Pavan, Jenny L. Diaz Castañeda, Maria F. Villa-Tamayo, Chaitanya L. K. Koravi, Giulio Santini, Carlene Alix, Meaghan Stumpf, and Sue A. Brown. The project was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (grant RO1 DK085623).
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