The objective of this proposal is to develop a prototype for the next generation multivariable automated
insulin delivery (mvAID) systems (also called artificial pancreas) by integrating systems engineering and
artificial intelligence (Al) techniques that will mitigate the effects of meals, physical activities ,acute
psychological stress inducements and sleep irregularities without manual inputs by the user to tightly
regulate the glucose levels of people with diabetes. The first generation of automated insulin delivery
(AID) systems relied on hybrid closed-loop technology, collecting data from continuous glucose monitoring
devices and requiring manual user inputs for mitigating the effects of meals and exercise. The multivariable
AID that we developed provides a well-integrated next-generation system that analyzes historical and realtime
data from different sources, including continuous glucose monitoring systems, insulin pumps, and
wearable sensors in wristband physical activity trackers, to mitigate the effects of meals, physical activities,
and acute psychological stress without manual inputs by the user. Meals, planned exercises, many
physical activities of daily living, acute psychological stress, and sleep irregularities affect blood glucose
levels differentially, challenging people with Type 1 diabetes to continuously consider all these complex
factors in maintaining their blood glucose levels in the target range. Further improvement in glucose
regulation can be achieved by developing novel, interpretable, and interactive Al techniques that can
explain their predictions to medical care providers and AID users, and by integrating these Al techniques
with systems engineering techniques to develop an Al-mvAID system. The function of these Al techniques
is to predict the state of a person based on historical trends and current data, and provide additional
valuable information to the mvAID system to relieve the users from onerous repetitive tasks for interpreting
their current metabolic state, predicting the impact of their current actions on future variations in glucose
levels, and tuning the parameters of the Al-mvAID controller. The goal is to produce a powerful userfriendly
technology that integrates novel Al techniques with mvAID systems for minimal user burden in
achieving tight control of glucose levels despite the many complex glycemic disturbances occurring in freeliving
conditions, such as meals, physical activities, acute psychological stress, and sleep irregularities.