Deep Reinforcement Learning for Closed-Loop Blood Glucose Control

TL;DR

This paper applies deep reinforcement learning to develop an adaptive, automated insulin control system for type 1 diabetes, significantly improving blood glucose management over traditional methods using extensive simulated patient data.

Contribution

It introduces novel deep RL algorithms for closed-loop blood glucose control, demonstrating superior performance and adaptability compared to existing control strategies.

Findings

RL approaches reduce median glycemic risk by nearly 50%

Total hypoglycemia days decreased by 99.8%

RL adapts effectively to meal timing predictability

Abstract

People with type 1 diabetes (T1D) lack the ability to produce the insulin their bodies need. As a result, they must continually make decisions about how much insulin to self-administer to adequately control their blood glucose levels. Longitudinal data streams captured from wearables, like continuous glucose monitors, can help these individuals manage their health, but currently the majority of the decision burden remains on the user. To relieve this burden, researchers are working on closed-loop solutions that combine a continuous glucose monitor and an insulin pump with a control algorithm in an `artificial pancreas.' Such systems aim to estimate and deliver the appropriate amount of insulin. Here, we develop reinforcement learning (RL) techniques for automated blood glucose control. Through a series of experiments, we compare the performance of different deep RL approaches to non-RL approaches. We highlight the flexibility of RL approaches, demonstrating how they can adapt to new individuals with little additional data. On over 2.1 million hours of data from 30 simulated patients, our RL approach outperforms baseline control algorithms: leading to a decrease in median glycemic risk of nearly 50% from 8.34 to 4.24 and a decrease in total time hypoglycemic of 99.8%, from 4,610 days to 6. Moreover, these approaches are able to adapt to predictable meal times (decreasing average risk by an additional 24% as meals increase in predictability). This work demonstrates the potential of deep RL to help people with T1D manage their blood glucose levels without requiring expert knowledge. All of our code is publicly available, allowing for replication and extension.