arXiv subjects

Jose Garcia-Tirado

Publications and source records attributed to Jose Garcia-Tirado.

4 recordsLinked to original sources

arXiv2026

Sensitivity-driven Personalization of a Glucoregulatory Model for Digital Twin Therapeutics in Type 1 Diabetes

Digital twins are increasingly used in diabetes research, but reproducing individual glucose dynamics requires accurate identification of glucoregulatory model parameters. Traditional sensitivity analysis can identify influential parameters, yet a ranking based on limited conditions may miss parameters that matter during specific disturbances or for particular individuals. We therefore examine both the magnitude and timing of parameter influence across dynamic input-output conditions and assess whether a common ranking holds across participants. We analyze the Hovorka glucoregulatory model using data from 192 participants receiving automated insulin delivery therapy in the Type 1 Diabetes and Exercise Initiative dataset. We extend Sobol sensitivity analysis to time series and rank parameter influence under four conditions: full-day profiles, isolated meal disturbances, insulin bolus injections, and postprandial responses. We combine the condition-specific results into a global ranking and use it to select parameters for participant-specific identification. Compared with population parameters, identification restricted to the sensitivity-derived subset reduces the root mean square error of 60-minute glucose predictions by 60%, to approximately 31 mg/dL. These findings suggest that a global ranking can capture parameter influence across individuals and dynamic conditions. By narrowing the parameters requiring identification, this approach reduces computational cost and could accelerate the development of personalized diabetes digital twins.

eess.SY↗

arXiv2026

Joint State-Parameter Inference Enhances Estimation Performance in Model-Based Digital Therapeutics for Type 1 Diabetes

Blood glucose estimation is the cornerstone of model-based decision support (DS) and Automated Insulin Delivery (AID) systems. Control systems that rely on physiologic/compartmental models depend heavily on model parameterization, which is either defined using population values or personalized through the user's data. Often, the model parameters are defined as constants. However, under real-world free-living conditions, fixed parameters can limit the accurate reconstruction and estimation of glucose levels and states. In this paper, we propose and discuss a recursive filtering framework for online joint state estimation and parameter identification in nonlinear, time-varying physiological models for Type 1 Diabetes (T1D). Specifically, we employ a Rao-Blackwellized Stein Variational Gradient Descent (RBSVGD) filter to compute the joint posterior distributions of model states and parameters. The proposed approach is applied to the Hovorka glucose-insulin model and validated using data generated by the the Oregon Health & Science University (OHSU) simulator across 20 virtual patients. We perform a comparative analysis against: (i) a standard Extended Kalman Filter (EKF) with fixed model parameters, and (ii) an Augmented Extended Kalman Filter (AEKF) for joint state-parameter estimation. The results demonstrate that the proposed RBSVGD-based framework outperforms both EKF and AEKF approaches not only in terms of the accuracy of glucose estimation, but also in terms of estimated model parameters.

eess.SY↗

arXiv2025

Advanced Hybrid Automated Insulin Delivery System based on Successive Linearization Model Predictive Control: The UniBE System

Background and objective: Hybrid automated insulin delivery (hAID) systems represent the most advanced therapy for type 1 diabetes (T1D). Current systems rely on linear or linearized models of glucose homeostasis, which may compromise prediction accuracy and, in turn, timely decision-making by the controller. Physiological variability further complicates insulin requirements, underscoring the need for controllers that adapt dynamically and reduce user burden. Methods: We introduce the University of Bern (UniBE) hAID system, a framework based on successive linearization model predictive control (MPC). The controller integrates basal insulin infusion with the insulin bolus delivery module for meal-related and corrective bolus dosing, adapting bounds in real time to glucose dynamics while accounting for both automated and user-initiated inputs. In-silico evaluation was conducted using the commercial version of the FDA-accepted UVa/Padova metabolic simulator across nine scenarios involving persistent and time-varying errors in meal timing, carbohydrate estimation, and basal insulin profiles. Results: In the baseline scenario, UniBE achieved a mean time in range of 92.0+-13.2%, with time below range at 0.1+-0.2% and time above range at 7.9+-13.2%. Across perturbation scenarios, time in range remained between 75.1 and 92.8%, with low hypoglycemia incidence, demonstrating resilience to clinically relevant disturbances.

eess.SY↗

arXiv2025

A Real-Time Digital Twin for Type 1 Diabetes using Simulation-Based Inference

Accurately estimating parameters of physiological models is essential to achieving reliable digital twins. For Type 1 Diabetes, this is particularly challenging due to the complexity of glucose-insulin interactions. Traditional methods based on Markov Chain Monte Carlo struggle with high-dimensional parameter spaces and fit parameters from scratch at inference time, making them slow and computationally expensive. In this study, we propose a Simulation-Based Inference approach based on Neural Posterior Estimation to efficiently capture the complex relationships between meal intake, insulin, and glucose level, providing faster, amortized inference. Our experiments demonstrate that SBI not only outperforms traditional methods in parameter estimation but also generalizes better to unseen conditions, offering real-time posterior inference with reliable uncertainty quantification.

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