2008 International Conference on Emerging Technologies

IEEE-ICET 2008
Rawalpindi, Pakistan, 18-19 October, 2008

Blood Glucose-Insulin Regulation and Management

System Using MATLAB/SIMULINK
Dr. Jameel Ahmed*, Dr. Bilal A. Alvi**, Zeeshan Ali khan*
*NFC Institute of Engineering and Technology, Multan, Pakistan
**Sir Syed University of Engineering & Technology, Karachi
Email: Jameel@nfciet.edu.pk

Abstract-Biomedical signal processing has exponentially been Diabetics are at increased risks for developing chronic
expanding and demanding area for research and subsequent complications such as heart attacks, strokes, kidney failure,
applications in its respective quarters. Exploration on diabetes is blindness and amputations. The majority of diabetic
one of the main segments of this area which is being addressed
population is classified as Type-I or Type-II. The former is
for the decades. One of the main functions of the pancreas is to
regulate glucose concentration in blood through release of the insulin dependent which accounts for 5-10% of the diabetic
enzyme insulin. Some theoretical analysis of the control of blood population whereas the latter is a non-insulin dependent
glucose level in diabetic individuals is undertaken using a simple diabetes mellitus, which accounts for 90-95% for the diabetic
mathematical model of the dynamics of glucose and insulin population [1].
interaction in the blood system developed by Stolwijk and Hardy
dynamic model [1]. This paper is focused to envisage the For patients with diabetes especially for Type-I, insulin-
regulation and management of the concentration of glucose and dependent diabetes, tight control of glucose level is essential.
insulin in the blood of a diabetic. The model was modified by Regulating blood glucose concentration using the insulin
adding a term for exogenous insulin infusion. Using this model, a
infusion device is important for these patients, because they
closed-loop feed back system which regulates and manages the
blood glucose-insulin has been designed, implemented and have deficiency of insulin production by pancreas that
analyzed using Matlab/Simulink. This system imitates as an prevents appropriate metabolism of glucose. Many patients,
artificial pancreas on day-to-day basis. A time-consuming and who take insulin infusion in their diabetes therapy, inject
tedious series of diabetes experiments was carried out and results insulin with needles and syringes that deliver insulin just
were analyzed on the basis of medical parameters. The obtained under the skin, so that the functions of the pancreas are
results showed significant regulation and management of the replaced by some external devices. An external insulin pump
glucose-insulin delivery in the blood. Hence, we are reasonably is an electro-medical device that delivers insulin through
confident of having contribution in the subject area. narrow and flexible plastic tubing that ends with a needle
Keywords-Insulin; pancreas; glucose-insulin, closed-loop control;
inserted just under the skin near the abdomen. The pump
Matlab/Simulation; diabetes, diabetic releases doses of insulin at meals and during the periods when
blood glucose is too high based on measured values of glucose
sensors [1].
1. INTRODUCTION A patient’s glucose concentration may change dynamically
depending mostly on his /her physical activities and nutrition,
Diabetes mellitus is a metabolic disorder in which insulin, a and therefore, the amount of insulin needed varies from time
kind of hormone which promotes the uptake of glucose into to time. A number of diseases may occur, possibly resulting in
cells, cannot properly perform its role. People with diabetes life-threatening health conditions if the supply of insulin is not
cannot produce enough insulin that is required to convert in time or not correctly dosed or fails for some reasons. For
sugar, starches and other food into energy needed for daily example, sustained hyperglycemia (blood glucose exceeding
life. Diabetes Mellitus is so far an incurable disease affecting 120 mg/dL) may lead to most of the long-term complications
million of people worldwide. Approximately 177 million associated with diabetes, such as nephropathy and retinopathy.
people have diabetes, and this number is expected to increase
to 300 million by the year 2025 [1].Scientists are focusing on The current medical treatments suggest three to four daily
developing a manifold of new techniques and feasible glucose measurements and an equivalent amount of
instrumentation to offer wearable solutions and improve the subcutaneous insulin injections. This method is not only
life of patients. The patient is totally dependent on an external inconvenient and painful but also unreliable due to the
source of insulin to be infused at an appropriate rate to approximation involved in the amount and type of insulin
maintain blood glucose level. The blood glucose level should delivered. Fortunately, a significant amount of research is
be controlled within the range of 60-120mg/dl . being carried out to overcome the shortcomings of the current
medical practice in which signal processing being dominating
field of Electrical Engineering has contributed noticeably.

978-1-4244-2211-1/08/$25.00 ©2008 IEEE

Hyperglycemia is common in critically ill patients and is not shows the block diagram of closed-loop control of diabetes
limited to patients who are known to be diabetic. Several patients.
recent studies have established a correlation between tight
glucose control and decreased preoperative morbidity and
mortality in surgical and critically ill patients. Applying these
findings to improve outcomes involves identifying patients at
risk for hyperglycemia, monitoring blood glucose frequently,
using an effective insulin infusion algorithm to control blood
glucose within a narrow range, and adjusting insulin infusion
rates in a timely and accurate manner. Adverse effects of
hyperglycemia include dehydration, increased susceptibility to Fig. 2. Closed-loop System for Diabetics
infection, and impaired wound healing. In fact, there are some
For patients with diabetes especially for Type-1, insulin-
data to suggest that aggressive glycemic management can help
dependent diabetes, tight control of glucose level is essential.
combat infection and several studies have showed a strong
Regulating blood glucose concentration using the insulin
association between hospital mortality and glycemic levels.
infusion device is important for these patients, because they
Whether the survival benefit is due to glycemic control or to
have deficiency of insulin production by pancreas that
insulin administration is still unresolved. The survival benefit
prevents appropriate metabolism of glucose. Many patients,
of intensive insulin therapy is likely multifactorial and
who take insulin infusion in their diabetes therapy, inject
regardless of the mechanism, optimizing glycemic control
insulin with needles and syringes that deliver insulin just
with insulin infusions clearly appears to be beneficial [2].
under the skin, so that the functions of the pancreas are
replaced by some external devices. An external insulin pump
A number of algorithms for controlling glucose levels with
is an electronic medical Device that delivers insulin through
insulin infusions are currently in use throughout the world.
narrow and flexible plastic tubing that ends with a needle
Most of these protocols specify adjustments in insulin infusion
inserted just under the skin near the abdomen. The pump
rates based on hourly measurements of blood glucose with
releases doses of insulin at meals and during the periods when
rescue administration of glucose for hypoglycemic episodes.
blood glucose is too high based on measured values of glucose
The development of insulin injection programs has generally
sensors [5].
proceeded along two fronts: open-loop method and closed-
loop method [3].
To-date, the current method of therapy for diabetics is a series
of 3~5 daily insulin injections with quantities of insulin based
A. Open Loop Method on 4~8 daily invasive glucose measurements. It is said that
infusion of insulin is discretely controlled by users based on
Open-loop systems deliver a predetermined amount of insulin the feedback of several blood glucose measurements [5]. It is
to the patient and the amount of insulin is based on the insulin obvious that such treatment is lack of a reliable continuous
curve of the normal pancreas secretion. Open-loop control monitoring, which may make glucose concentration out of
block diagram shown in Fig.1. permitted range because of control delay. In other words, this
kind of therapy cannot restore metabolism to a state of a
healthy patient, and wide glucose fluctuations continue to
occur on many patients.

Therefore, it is urgent to design a continuous closed-loop

control system for insulin infusion. The continuous control
would be a great improvement in the daily treatment of
Fig. 1. Open-loop Control for Diabetics diabetes, especially in some cases that medical persons are not
presented or the patients have less knowledge about the
disease. Such an automatic control will benefit patients and
B. Closed Loop Method
avoid some mistakes during injections and operations [5].
In the closed-loop control system, a glucose sensor is needed II. GLUCOSE-INSULIN REGULATION MODEL
that can measure blood glucose level. This information then
would be passed to a control system that would calculate the
In order to study the effects of glucose and insulin
necessary insulin delivery rate to keep the blood glucose level
regulation in body we need a model of a pancreatic function.
in a stable range. Then a electro-medical device will deliver
One of the main functions of the pancreas is to regulate the
the desired amount of insulin. In general, the closed-loop
glucose concentration in the blood through release of the
method is more reliable in maintaining the level of blood
enzyme insulin. In a normal patient, insulin tightly regulates
glucose and also is close to the normal pancreas [4]. Fig.2
the metabolism of glucose. Diabetes patients suffer from a
dysfunction of this process. The glucose-insulin regulation
model used is based on Stolwijk and Hardy’s dynamic model
[5]. The model was modified by adding a term for exogenous
insulin infusion. Hence, the glucose dynamics are governed by
following equations [5]. Therefore, our work is based on the
research carried out by [1-5].
Fig. 3. Two-input Two-output pancreatic model

CG = UG + QG-λ G – νGI, G≤ θ .…..(1) III. DESIGN PARAMETERS FOR PANCREATIC MODEL

The pancreatic model according to the dynamic equations

CG = UG + QG-λ G – νGI - µ (G - θ), G> θ, (1) and (2) can effectively and efficiently be implemented in
Matlab/Simulink with the help of parameters mentioned in
Table 1. Accordingly, Plasma volume and interstitial fluid
volume are represented in a single compartment (3L+12L, in
CI = UI – α I G≤ φ …… (2) the normal adult) with constant volume). The steady state
concentration of glucose in this compartment is x (in mg/mL).
Glucose enters through absorption from the Glucose-Insulin
CI = UI – α I + β (G- φ) G> φ tract or through production from the liver at the flow rate of Q
(G) t in (mg/h). Glucose leaves the extracellular volume to
enter the cells to be metabolized and/or stored. In insulin
Where, independent tissue the rate of glucose utilization depends only
on the extracellular to intracellular glucose gradient. The
G = Instantaneous blood glucose level in mg/dl intracellular concentration is ignored Glucose uptake in insulin
I = Instantaneous blood insulin level mU/d dependent tissue is facilitated by insulin concentration (y).
U G = Exogenous glucose infusion in mg/h Therefore, the rate of insulin dependent glucose utilization UI
(t) is given as
UI = Exogenous insulin infusion in mU/h
CG = Glucose capacitance in the extra cellular space UI (t) = νy
CI = Insulin capacitance in the extra cellular space
Insulin is produced at a rate dependent on plasma glucose
OG = Glucose inflow into blood in mg/h levels. However if x falls below a certain threshold insulin
secretion ceases. Insulin is removed from the plasma involving
Λ = Tissue usage rate of glucose that is independent of I (t) the insulinase enzyme at a rate proportional to its
Ν = Tissue usage rate of glucose that is dependent on I (t) concentration in blood. The steady state concentration for
Α = Insulin destruction rate insulin (y) is given as
Β = Insulin production rate by the pancreas
Θ = Threshold for renal discharge of glucose
Φ = Threshold for pancreatic production of insulin Y= 0 , X= φ
µ = Constant proportionality factor (gain) Y= α (X- φ) , X> φ

Glucose inflow into the blood can be either through absorption The steady state level of glucose and insulin in the blood
from the gastrointestinal tract or through production from the under a given set of conditions can be predicted from solving
liver. In addition, as seen from the parameter descriptions these equations simultaneously. Further, the following
above, the coefficients have physiological significance, and parameter values are used for pancreatic model.
also differ depending on the condition of the patient. Type-1
Diabetic Mellitus (DM) patients lack the capacity to produce Table 1: Parameters for Pancreatic Model
adequate amounts of insulin, The glucose-insulation Parameters Values
regulation model, which is described in equations (1) and (2) G(t) 2.5 mg/mL
and comprises an internal feedback loop provided by the µ 7200 mL/h
pancreas, can be thought of as a two-input and two-output λ 2470 mL/h
dynamic system as shown in Fig.3 ν 139000 l/(mUh)
φ 0.51mg/mL
β 1430mUmL/(mgh)
α 7600mL/h
QG (t) 8400mg/h
Based on the parameters shown in Table 1, glucose-insulin or fasting or random because it really plays a very important role
pancreatic model, Figure 4, is designed; implemented and in the management of insulin for diabetic.
analyzed using Matlab/Simulink Release 14. The model
exhibits the pancreatic functionality by adopting the closed-
loop feedback system approach.

Fig. 5. Blood Glucose Concentration (X)

Fig. 4. Simulink Model of glucose-insulin regulation control system

IV. RESULTS AND DISCUSSION

Matlab/Simulink is used to simulate the pancreatic model by

using the parameters stated in Table 1. Each block has been
implemented with meticulous approach and various signals are
employed for the purpose of glucose-insulin representation.
Subsequent to the successful implementation of the model,
Fig. 4, an exhaustive series of experiments was carried out for
the insulin versus glucose level.

Fig. 5 demonstrates the blood glucose concentration in mg/dl

against time interval which is taken into minutes to match the
practical approach of the diabetic. The graph clearly shows the
abrupt rise of glucose level and then coming to steady state Fig. 6. Blood Insulin concentration
after certain period of time. On the contrary, Fig. 6
demonstrates the infusion of level of insulin in mU/ML
against time interval. It is to be pointed out that, the release of
level of insulin is according to the level of glucose level
thereby regulating and managing the amount of insulin to be From the above simulated model we see how a natural
required by a diabetic on different time intervals. Further, the pancreas model can be imitated as an artificial pancreatic
precision and accuracy of the regulation and management is model by using Simulink. As the blood-glucose becomes
overwhelmingly dependent on the parameters described in unstable the pancreas secretes insulin to regulate and control
Table 1. Therefore, to achieve the results demonstrated over the blood glucose to its stable and controllable point. We
here, truly, needed well concentrated and specific selection of observe that, as the blood-glucose concentration ‘x’
Simulink blocks and various signals for the faithful and approaches to its peak value the pancreas secretes insulin
successful achievement of the proposed model accordingly and when blood-glucose level is at its peak the
insulin concentration secreted by pancreas is also at its peak
In this closed-loop system, the demonstrated results have level which shows a proportional relation between glucose and
taken into account the different modes of glucose level like insulin in the body. As soon as the blood-glucose level
approaches to stability or controllable state the pancreas [4 ] J.Geoffrey Chase,Z-H Lan,J-Y Lee,and K-S Hwang, “Active
secretion becomes slow till it comes to stable state in the body. Insulin Infusion Control of the Blood Glucose Derivative,”
Seventh International Conference on Cootrol, Automation,
pp.1162-1167,December 2002

V. CONCLUSION
[5] Jiming Chen, Kejie Cao, 1 You Xian Sun, Yang Xiao, and Xu
A closed-loop pancreatic model for the regulation and (Kevin) Su, “Continuous Drug Infusion for Diabetes Therapy: A
Closed-Loop Control System Design” Received 15 July 2007;
management of glucose-insulin has been designed, Revised 25 November 2007; Accepted 5 December 2007
implemented and analyzed by using dynamic equation
parameters for the diabetics. The model is simulated with the
help of Matlab/Simulink and performed variety of experiments
over the period of last one year. The analysis based on the
results obtained on the proposed model show significant
regulation and management of the glucose-insulin by
exhibiting notable proportion of parameters. Though various
aspects of the diabetic are catered for in the implementation
and subsequent exercise of results, nevertheless, we
understand that it is so demanding and absorbing area for
research that the work could substantially be carried forward
in following directions as a future work:

1. Improvement of the mathematical model of insulin-

curve

2. Enhancement of efficiency and reliability of sensor in

closed-loop system

3. Biological compatibility of sensor, electro-medical

device and diabetic

4. Finally, the model needs to be transformed on

efficient and high speed hardware.

VI. ACKNOWLEDGEMENT

We sincerely acknowledge the research of authors [1-5], who

undoubtedly served the human being by carrying out their
research in this area and, as a result, we also attempted to take
this piece of work from their contribution.

VI. REFERENCES

[1] Pinky Dua, Francis J .Doyle, and Pistikopoulos, “Model-Based Blood

Glucose Control for Type 1 Diabetes via Parametric Programming,”
IEEE Transactions on Biomedical Engineering, vol.53, pp.1478-1491,
August 2006

[2] Nicolas W. Chbat, Tuhin K. Roy “Glycemic Control in

Critically Ill Patients – Effect of Delay in Insulin
Administration” Proceedings of the 2005 IEEE Engineering in
Medicine and Biology 27th Annual Conference Shanghai,
China, September 1-4, 2005

[3] Zlatko Trajanoski, Paul Wach, “Neural Predictive Controller for

Insulin Delivery Using the Subcutaneous Route,”IEEE
Transactions on Biomedical Engineering, vol.45, pp: 1122-1134,
1998