An Online Stochastic Optimization Approach for Insulin Intensification in Type 2 Diabetes with Attention to Pseudo-Hypoglycemia

In this paper, we present a model free approach to calculate long-acting insulin doses for Type 2 Diabetic (T2D) subjects in order to bring their blood glucose (BG) concentration to be within a safe range. The proposed strategy tunes the parameters of a proposed control law by using a zeroth-order online stochastic optimization approach for a defined cost function. The strategy uses gradient estimates obtained by a Recursive Least Square (RLS) scheme in an adaptive moment estimation based approach named AdaBelief. Additionally, we show how the proposed strategy with a feedback rating measurement can accommodate for a phenomena known as relative hypoglycemia or pseudo-hypoglycemia (PHG) in which subjects experience hypoglycemia symptoms depending on how quick their BG concentration is lowered. The performance of the insulin calculation strategy is demonstrated and compared with current insulin calculation strategies using simulations with three different models.