Prediction of postprandial blood glucose under intra-patient variability and uncertainty and its use in the design of insulin dosing strategies for type 1 diabetic patients

In this thesis I propose a novel method to estimate the dose and injection-to-meal time for low-risk intensive insulin therapy. This dosage-aid system uses an optimization algorithm to determine the insulin dose and injection-to-meal time that minimizes the risk of postprandial hyper- and hypoglycaemia in type 1 diabetic patients. To this end, the algorithm applies a methodology that quantifies the risk of experiencing different grades of hypo- or hyperglycaemia in the postprandial state induced by insulin therapy according to an individual patient’s parameters. This methodology is based on modal interval analysis (MIA). Applying MIA, the postprandial glucose level is predicted with consideration of intra-patient variability and other sources of uncertainty. A worst-case approach is then used to calculate the risk index. In this way, a safer prediction of possible hyper- and hypoglycaemic episodes induced by the insulin therapy tested can be calculated in terms of these uncertainties.

Group preference structures in AHP–group decision making

This paper presents a procedure that allows us to determine the preference structures (PS) associated to each of the different groups of actors that can be identified in a group decision making problem with a large number of individuals. To that end, it makes use of the Analytic Hierarchy Process (AHP) (Saaty, 1980) as the technique to solve discrete multicriteria decision making problems. This technique permits the resolution of multicriteria, multienvironment and multiactor problems in which subjective aspects and uncertainty have been incorporated into the model, constructing ratio scales corresponding to the priorities relative to the elements being compared, normalised in a distributive manner (wi = 1). On the basis of the individuals’ priorities we identify different clusters for the decision makers and, for each of these, the associated preference structure using, to that end, tools analogous to those of Multidimensional Scaling. The resulting PS will be employed to extract knowledge for the subsequent negotiation processes and, should it be necessary, to determine the relative importance of the alternatives being compared using anyone of the existing procedures