PID versus MPC Algorithm Response to Unannounced Meals in Adolescents
This crossover pilot compares the reactivity of two commercial automated insulin delivery algorithms to unannounced small carbohydrate and mixed meals, informing device-selection counseling for adolescents prone to missed boluses.
The PID algorithm optimizes glycemic control for unannounced meals in adolescents with type 1 diabetes.
Managing unannounced meals is a critical aspect of diabetes care for adolescents to prevent glycemic excursions. The proportional-integral-derivative (PID) algorithm showed better glucose control after unannounced meals, with lower two-hour blood glucose differences (ΔBG) compared to the model predictive control (MPC), without safety issues. While both algorithms are effective, the PID algorithm may provide superior glycemic control for unannounced carbohydrate-rich meals, highlighting its usefulness for adolescent patients with type 1 diabetes. The study's small size limits generalizability. PID algorithm excels in handling unannounced meals in type 1 diabetes.
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Authors:Lo Presti D, Scirè Calabrisotto S, Tomaselli LG, Pezzino G, Frasca F, Baratta R, Sciacca L, Latina C, La Spina N, Galeano F, Oteri V, Tumminia A
Citation:Lo Presti D, Scirè Calabrisotto S, Tomaselli LG, et al. The CRUMB study: closed-loop response to unannounced mixed and carbohydrates-rich breakfasts. A randomized controlled crossover pilot-study in a cohort of adolescents with type 1 diabetes. Endocrine. 2026;91(1). doi:10.1007/s12020-026-04705-5