Towards a Model-Based Meal Detector for Type I Diabetics

Blood glucose management systems are an important class of Medical Cyber-Physical Systems that provide vital everyday decision support service to diabetics. An artificial pancreas, which integrates a continuous glucose monitor, a wearable insulin pump, and control algorithms running on embedded computing devices, can significantly improve the quality of life for millions of Type 1 diabetics. A primary problem in the development of an artificial pancreas is the accurate detection and estimation of meal carbohydrates, which cause significant glucose system disturbances. Meal carbohydrate detection is challenging since post-meal glucose responses greatly depend on patient-specific physiology and meal composition. In this paper, we develop a novel meal-time detector that leverages a linearized physiological model to realize a (nearly) constant false alarm rate (CFAR) performance despite unknown model parameters and uncertain meal inputs. Insilico evaluations using 10, 000 virtual subjects on an FDA-accepted maximal physiological model illustrate that the proposed CFAR meal detector significantly outperforms a current state-of-the-art meal detector that utilizes a voting scheme based on rate-of-change (RoC) measures. The proposed detector achieves 99.6% correct detection rate while averaging one false alarm every 24 days (a 1.4% false alarm rate), which represents an 84% reduction in false alarms and a 95% reduction in missed alarms when compared to the RoC approach.