Roman Hovorka

Summary

Affiliation: University of Cambridge
Country: UK

Publications

  1. ncbi request reprint Associations of glucose control with insulin sensitivity and pancreatic beta-cell responsiveness in newly presenting type 2 diabetes
    Ahmed I Albarrak
    Metabolic Modelling Group, Centre for Measurement and Information in Medicine, City University, London, EC1V OHB, United Kingdom
    J Clin Endocrinol Metab 87:198-203. 2002
  2. ncbi request reprint Blood glucose control by a model predictive control algorithm with variable sampling rate versus a routine glucose management protocol in cardiac surgery patients: a randomized controlled trial
    Roman Hovorka
    Department of Pediatrics, University of Cambridge, UK
    J Clin Endocrinol Metab 92:2960-4. 2007
  3. ncbi request reprint The future of continuous glucose monitoring: closed loop
    Roman Hovorka
    Diabetes Modelling Group, Institute of Medical Science, University of Cambridge, Box 289, Addenbrooke s Hospital, Hills Road, Cambridge CB2 0QQ, UK
    Curr Diabetes Rev 4:269-79. 2008
  4. pmc Closed-loop basal insulin delivery over 36 hours in adolescents with type 1 diabetes: randomized clinical trial
    Daniela Elleri
    Department of Paediatrics, University of Cambridge, Cambridge, UK
    Diabetes Care 36:838-44. 2013
  5. pmc Overnight closed-loop insulin delivery in young people with type 1 diabetes: a free-living, randomized clinical trial
    Roman Hovorka
    Corresponding author Roman Hovorka
    Diabetes Care 37:1204-11. 2014
  6. ncbi request reprint Feasibility of closed-loop insulin delivery in type 2 diabetes: a randomized controlled study
    Kavita Kumareswaran
    Corresponding author Roman Hovorka
    Diabetes Care 37:1198-203. 2014
  7. pmc Assessing performance of closed-loop insulin delivery systems by continuous glucose monitoring: drawbacks and way forward
    Roman Hovorka
    Metabolic Research Laboratories, Institute of Metabolic Science, Cambridge, United Kingdom
    Diabetes Technol Ther 15:4-12. 2013
  8. pmc Validity of triple- and dual-tracer techniques to estimate glucose appearance
    A Haidar
    Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, United Kingdom
    Am J Physiol Endocrinol Metab 302:E1493-501. 2012
  9. doi request reprint A simulation model of glucose regulation in the critically ill
    Roman Hovorka
    Institute of Metabolic Science, Metabolic Research Laboratories, Level 4, Box 289, Addenbrooke s Hospital, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
    Physiol Meas 29:959-78. 2008
  10. doi request reprint Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial
    Roman Hovorka
    Department of Paediatrics, University of Cambridge, Cambridge, UK
    Lancet 375:743-51. 2010

Detail Information

Publications49

  1. ncbi request reprint Associations of glucose control with insulin sensitivity and pancreatic beta-cell responsiveness in newly presenting type 2 diabetes
    Ahmed I Albarrak
    Metabolic Modelling Group, Centre for Measurement and Information in Medicine, City University, London, EC1V OHB, United Kingdom
    J Clin Endocrinol Metab 87:198-203. 2002
    ..Indices of insulin sensitivity and pancreatic beta-cell responsiveness explain fasting glucose and HbA(1C) well but fail to explain postprandial glucose...
  2. ncbi request reprint Blood glucose control by a model predictive control algorithm with variable sampling rate versus a routine glucose management protocol in cardiac surgery patients: a randomized controlled trial
    Roman Hovorka
    Department of Pediatrics, University of Cambridge, UK
    J Clin Endocrinol Metab 92:2960-4. 2007
    ..Elevated blood glucose levels occur frequently in the critically ill. Tight glucose control by intensive insulin treatment markedly improves clinical outcome...
  3. ncbi request reprint The future of continuous glucose monitoring: closed loop
    Roman Hovorka
    Diabetes Modelling Group, Institute of Medical Science, University of Cambridge, Box 289, Addenbrooke s Hospital, Hills Road, Cambridge CB2 0QQ, UK
    Curr Diabetes Rev 4:269-79. 2008
    ..The most important question is what is achievable with existing technologies and when the first generation of closed-loop systems will find its way into clinical practice...
  4. pmc Closed-loop basal insulin delivery over 36 hours in adolescents with type 1 diabetes: randomized clinical trial
    Daniela Elleri
    Department of Paediatrics, University of Cambridge, Cambridge, UK
    Diabetes Care 36:838-44. 2013
    ..We evaluated the safety and efficacy of closed-loop basal insulin delivery during sleep and after regular meals and unannounced periods of exercise...
  5. pmc Overnight closed-loop insulin delivery in young people with type 1 diabetes: a free-living, randomized clinical trial
    Roman Hovorka
    Corresponding author Roman Hovorka
    Diabetes Care 37:1204-11. 2014
    ..To evaluate feasibility, safety, and efficacy of overnight closed-loop insulin delivery in free-living youth with type 1 diabetes...
  6. ncbi request reprint Feasibility of closed-loop insulin delivery in type 2 diabetes: a randomized controlled study
    Kavita Kumareswaran
    Corresponding author Roman Hovorka
    Diabetes Care 37:1198-203. 2014
    ..Our aim was to evaluate the feasibility of fully closed-loop subcutaneous insulin delivery in insulin-naïve patients with type 2 diabetes...
  7. pmc Assessing performance of closed-loop insulin delivery systems by continuous glucose monitoring: drawbacks and way forward
    Roman Hovorka
    Metabolic Research Laboratories, Institute of Metabolic Science, Cambridge, United Kingdom
    Diabetes Technol Ther 15:4-12. 2013
    ..We investigated whether continuous glucose monitoring (CGM) levels can accurately assess glycemic control while directing closed-loop insulin delivery...
  8. pmc Validity of triple- and dual-tracer techniques to estimate glucose appearance
    A Haidar
    Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, United Kingdom
    Am J Physiol Endocrinol Metab 302:E1493-501. 2012
    ..The TT technique tends to outperform slightly the DT technique, but the latter benefits from reduced experimental and computational complexity...
  9. doi request reprint A simulation model of glucose regulation in the critically ill
    Roman Hovorka
    Institute of Metabolic Science, Metabolic Research Laboratories, Level 4, Box 289, Addenbrooke s Hospital, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
    Physiol Meas 29:959-78. 2008
    ..In conclusion, a novel glucoregulatory model has been developed to create a virtual population of critically ill facilitating in silico testing of glucose controllers at the intensive care unit...
  10. doi request reprint Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial
    Roman Hovorka
    Department of Paediatrics, University of Cambridge, Cambridge, UK
    Lancet 375:743-51. 2010
    ..Closed-loop systems link continuous glucose measurements to insulin delivery. We aimed to establish whether closed-loop insulin delivery could control overnight blood glucose in young people...
  11. ncbi request reprint Calculating glucose fluxes during meal tolerance test: a new computational approach
    Roman Hovorka
    Diabetes Modelling Group, Dept of Paediatrics, Univ of Cambridge, Box 116, Addenbrooke s Hospital, Hills Road, Cambridge CB2 2QQ, UK
    Am J Physiol Endocrinol Metab 293:E610-9. 2007
    ..An example study is shown demonstrating the utility of the approach. A better performance of the new method is demonstrated in a simulation study...
  12. doi request reprint Closed-loop insulin delivery: from bench to clinical practice
    Roman Hovorka
    Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
    Nat Rev Endocrinol 7:385-95. 2011
    ....
  13. pmc Overnight closed loop insulin delivery (artificial pancreas) in adults with type 1 diabetes: crossover randomised controlled studies
    Roman Hovorka
    Institute of Metabolic Science, University of Cambridge, Cambridge, UK
    BMJ 342:d1855. 2011
    ..To compare the safety and efficacy of overnight closed loop delivery of insulin (artificial pancreas) with conventional insulin pump therapy in adults with type 1 diabetes...
  14. pmc Overnight closed-loop insulin delivery with model predictive control: assessment of hypoglycemia and hyperglycemia risk using simulation studies
    Malgorzata E Wilinska
    Cambridge University Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
    J Diabetes Sci Technol 3:1109-20. 2009
    ..Additionally, a comparison was made against incidence observed experimentally during open-loop single-night in-clinic studies in young people with type 1 diabetes mellitus (T1DM) treated by continuous SC insulin infusion...
  15. pmc Evaluating the accuracy and large inaccuracy of two continuous glucose monitoring systems
    Lalantha Leelarathna
    Metabolic Research Laboratories, Institute of Metabolic Science, Cambridge, UK
    Diabetes Technol Ther 15:143-9. 2013
    ..San Diego, CA) continuous glucose monitoring (CGM) systems during closed-loop studies...
  16. ncbi request reprint Evaluation of a portable ambulatory prototype for automated overnight closed-loop insulin delivery in young people with type 1 diabetes
    Daniela Elleri
    Metabolic Research Laboratories, Institute of Metabolic Science, Cambridge, UK
    Pediatr Diabetes 13:449-53. 2012
    ..To evaluate an ambulatory, portable prototype, overnight automated closed-loop (CL) system and to explore optimal time of CL initiation...
  17. pmc Closed-loop insulin delivery during pregnancy complicated by type 1 diabetes
    Helen R Murphy
    Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Hills Road, Cambridge, UK
    Diabetes Care 34:406-11. 2011
    ..This study evaluated closed-loop insulin delivery with a model predictive control (MPC) algorithm during early (12-16 weeks) and late gestation (28-32 weeks) in pregnant women with type 1 diabetes...
  18. doi request reprint Evaluating glycemic control algorithms by computer simulations
    Malgorzata E Wilinska
    Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
    Diabetes Technol Ther 13:713-22. 2011
    ..Their strengths and weaknesses are difficult to assess without head-to-head comparison in time-consuming clinical trials. We hypothesized that computer simulations may be useful...
  19. pmc Simulation environment to evaluate closed-loop insulin delivery systems in type 1 diabetes
    Malgorzata E Wilinska
    Cambridge University Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke s Hospital, Cambridge, UK
    J Diabetes Sci Technol 4:132-44. 2010
    ..We present a simulation environment designed to support the development and testing of closed-loop insulin delivery systems in type 1 diabetes mellitus (T1DM)...
  20. pmc Safety and efficacy of 24-h closed-loop insulin delivery in well-controlled pregnant women with type 1 diabetes: a randomized crossover case series
    Helen R Murphy
    Metabolic Research Laboratories and the National Institute for Health Research Cambridge Biomedical Research Center, University of Cambridge, Cambridge, UK
    Diabetes Care 34:2527-9. 2011
    ..To evaluate the safety and efficacy of closed-loop insulin delivery in well-controlled pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII)...
  21. pmc Accuracy of continuous glucose monitoring during exercise in type 1 diabetes pregnancy
    Kavita Kumareswaran
    University of Cambridge Metabolic Research Laboratories and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, United Kingdom
    Diabetes Technol Ther 15:223-9. 2013
    ..Our aim was to evaluate accuracy of a current-generation CGM during moderate-intensity exercise in type 1 diabetes (T1D) pregnancy...
  22. pmc Meta-analysis of overnight closed-loop randomized studies in children and adults with type 1 diabetes: the Cambridge cohort
    Kavita Kumareswaran
    Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
    J Diabetes Sci Technol 5:1352-62. 2011
    ....
  23. doi request reprint Parental attitudes towards overnight closed-loop glucose control in children with type 1 diabetes
    Daniela Elleri
    Department of Paediatrics, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
    Diabetes Technol Ther 12:35-9. 2010
    ..This study examined parental attitudes towards overnight closed-loop (CL) glucose control in children and young people with type 1 diabetes (T1D)...
  24. doi request reprint Automated overnight closed-loop glucose control in young children with type 1 diabetes
    Daniela Elleri
    Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
    Diabetes Technol Ther 13:419-24. 2011
    ..We evaluated the effectiveness of automated overnight closed-loop (AOCL) insulin delivery and the influence of timing of initiation on glucose control overnight in young children with type 1 diabetes (T1D)...
  25. ncbi request reprint Effect of delay on measurement of blood glucose levels in young subjects with type 1 diabetes
    Daniela Elleri
    Department of Paediatrics, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
    Diabetes Res Clin Pract 86:e31-3. 2009
    ..Blood glucose decreased by 0.47 mmol/L despite samples being collected in fluoride tubes and placed on ice. The extent of reduction differs among subjects, prevailing blood glucose and time-of-day of sample withdrawal...
  26. ncbi request reprint Insulin kinetics in type-I diabetes: continuous and bolus delivery of rapid acting insulin
    Malgorzata E Wilinska
    Department of Paediatrics, University of Cambridge, Cambridge, CB2 2QQ, UK
    IEEE Trans Biomed Eng 52:3-12. 2005
    ....
  27. ncbi request reprint Interstitial glucose kinetics in subjects with type 1 diabetes under physiologic conditions
    Malgorzata E Wilinska
    Department of Paediatrics, University of Cambridge, Addenbrooke s Hospital, Cambridge CB2 2QQ, UK
    Metabolism 53:1484-91. 2004
    ..In conclusion, we developed and quantified a model of IG kinetics in the adipose tissue applicable to physiologic conditions in subjects with T1DM...
  28. ncbi request reprint Nonlinear model predictive control of glucose concentration in subjects with type 1 diabetes
    Roman Hovorka
    Diabetes Modelling Group, Department of Paediatrics, University of Cambridge, Box 116, Addenbrooke s Hospital, Hills Road, Cambridge CB2 2QQ, UK
    Physiol Meas 25:905-20. 2004
    ..In conclusion, adaptive nonlinear model predictive control is promising for the control of glucose concentration during fasting conditions in subjects with type 1 diabetes...
  29. ncbi request reprint Artificial pancreas: an emerging approach to treat Type 1 diabetes
    Kavita Kumareswaran
    Institute of Metabolic Science, University of Cambridge, Metabolic Research Laboratories, Box 289, Level 4, Addenbrooke s Hospital, Hills Road, Cambridge, CB2 0QQ, UK
    Expert Rev Med Devices 6:401-10. 2009
    ..In this article, we review closed-loop glucose control, including its components, development, testing and clinical application...
  30. pmc Accuracy of subcutaneous continuous glucose monitoring in critically ill adults: improved sensor performance with enhanced calibrations
    Lalantha Leelarathna
    1 Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
    Diabetes Technol Ther 16:97-101. 2014
    ..We evaluated the accuracy of the FreeStyle(®) Navigator(®) (Abbott Diabetes Care, Alameda, CA) subcutaneous continuous glucose monitoring (CGM) device in critically ill adults using two methods of calibration...
  31. pmc Physical activity energy expenditure and glucose control in pregnant women with type 1 diabetes: is 30 minutes of daily exercise enough?
    Kavita Kumareswaran
    University of Cambridge Metabolic Research Laboratories, Cambridge, UK
    Diabetes Care 36:1095-101. 2013
    ..To describe activity patterns in pregnant women with type 1 diabetes and evaluate the impact of increased structured physical activity on glucose control...
  32. ncbi request reprint Grading system to assess clinical performance of closed-loop glucose control
    Ludovic J Chassin
    Diabetes Modelling Group, Department of Paediatrics, University of Cambridge, Addenbrooke s Hospital, Cambridge, United Kingdom
    Diabetes Technol Ther 7:72-82. 2005
    ..We conclude that the grading system provides suitable means to assess efficacy and safety of glucose controllers complementing existing measures of glucose control...
  33. ncbi request reprint Closing the loop: the adicol experience
    Roman Hovorka
    Diabetes Modelling Group, Department of Paediatrics, University of Cambridge, Addenbrooke s Hospital, Cambridge, United Kingdom
    Diabetes Technol Ther 6:307-18. 2004
    ..The ADICOL project demonstrated feasibility of a semi-closed-loop glucose control during fasting and fed conditions with a wearable, modular extracorporeal artificial pancreas...
  34. ncbi request reprint Evaluation of glucose controllers in virtual environment: methodology and sample application
    Ludovic J Chassin
    Diabetes Modelling Group, Department of Paediatrics, University of Cambridge, Box 116, Addenbrooke s Hospital, Hills Road, Cambridge CB2 2QQ, UK
    Artif Intell Med 32:171-81. 2004
    ..The objective of the present work is to develop a methodology to test glucose controllers of an artificial pancreas in a simulated (virtual) environment...
  35. pmc Closed-loop insulin delivery in type 1 diabetes
    Hood Thabit
    Institute of Metabolic Science, Addenbrookes Hospital, University of Cambridge, Box 289, Level 4, Cambridge CB2 0QQ, UK
    Endocrinol Metab Clin North Am 41:105-17. 2012
    ..The artificial pancreas prototypes currently used in clinical studies are reviewed as well as obstacles and limitations facing the technology...
  36. ncbi request reprint Estimating postprandial glucose fluxes using hierarchical Bayes modelling
    Ahmad Haidar
    University of Cambridge Metabolic Research Laboratories, Cambridge, UK
    Comput Methods Programs Biomed 108:102-12. 2012
    ..2±1.3; new method vs. ML method; P<0.01, paired t-test). We conclude that the new method increases plausibility of the endogenous glucose production and improves accuracy of glucose disposal compared to the maximum likelihood method...
  37. ncbi request reprint Automated glucose control in the ICU: effect of nutritional protocol and measurement error
    Malgorzata E Wilinska
    Dept of Paediatrics, University of Cambridge, UK
    Conf Proc IEEE Eng Med Biol Soc 1:67-70. 2006
    ..We conclude that nutritional protocol should be kept simple to facilitate efficacious glucose control with an adaptive model predictive controller. The measurement error of the glucose measuring device should be less or equal to 10%..
  38. pmc Insulin administration and rate of glucose appearance in people with type 1 diabetes
    Mary E Pennant
    Medical Research Council, Human Nutrition Research, Cambridge, UK
    Diabetes Care 31:2183-7. 2008
    ..To assess whether prandial insulin, in addition to basal insulin, has an effect on the rate of glucose appearance from a meal in people with type 1 diabetes...
  39. ncbi request reprint Closed-loop insulin delivery: towards improved diabetes care
    Kavita Kumareswaran
    Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
    Discov Med 13:159-70. 2012
    ..Outpatient evaluation is required as the next step, leading to deployment into clinical practice...
  40. pmc Closed-loop insulin delivery for treatment of type 1 diabetes
    Daniela Elleri
    Department of Paediatrics and Institute of Metabolic Science, University of Cambridge, Hills Road, Cambridge, CB2 0QQ, UK
    BMC Med 9:120. 2011
    ....
  41. doi request reprint Treatment with recombinant human insulin-like growth factor (rhIGF)-I/rhIGF binding protein-3 complex improves metabolic control in subjects with severe insulin resistance
    Fiona M Regan
    University of Cambridge, Department of Pediatrics, Cambridge, United Kingdom
    J Clin Endocrinol Metab 95:2113-22. 2010
    ..We report clinical and physiological outcomes after adjunctive therapy with rhIGF-I/rhIGFBP-3 in five subjects with SIR...
  42. ncbi request reprint Day and night home closed-loop insulin delivery in adults with type 1 diabetes: three-center randomized crossover study
    Lalantha Leelarathna
    Wellcome Trust Medical Research Clinical Institute of Metabolic Science, University of Cambridge, Cambridge, U K Department of Diabetes and Endocrinology, Addenbrooke s Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, U K
    Diabetes Care 37:1931-7. 2014
    ..To evaluate the feasibility of day and night closed-loop insulin delivery in adults with type 1 diabetes under free-living conditions...
  43. doi request reprint Bringing closed-loop home: recent advances in closed-loop insulin delivery
    Hood Thabit
    Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
    Curr Opin Endocrinol Diabetes Obes 21:95-101. 2014
    ..To highlight the recent advances in closed-loop research, the development and progress towards utilizing closed loop outside of the clinical research setting and at patients' homes...
  44. ncbi request reprint Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients
    Johannes Plank
    Department of Internal Medicine, Medical University Hospital, Graz, Auenbruggerplatz 15, 8036 Graz, Austria
    Diabetes Care 29:271-6. 2006
    ....
  45. ncbi request reprint Population and individual minimal modeling of the frequently sampled insulin-modified intravenous glucose tolerance test
    Lars Erichsen
    Pharmacometrics, Novo Nordisk A S, Bagsvaerd, Denmark
    Metabolism 53:1349-54. 2004
    ..The standard two-stage technique is the preferred method under such circumstances...
  46. ncbi request reprint Bayesian hierarchical approach to estimate insulin sensitivity by minimal model
    Olorunsola F Agbaje
    Metabolic Modelling Group, Centre for Measurement and Information in Medicine, City University, Northampton Square, London EC1V OHB, UK
    Clin Sci (Lond) 105:551-60. 2003
    ..99; P <0.001). We conclude that the Bayesian hierarchical analysis is an appealing method to estimate SI and SG, as it avoids parameter estimation failures, and should be considered when investigating insulin-resistant subjects...
  47. ncbi request reprint Partitioning glucose distribution/transport, disposal, and endogenous production during IVGTT
    Roman Hovorka
    Centre for Measurement and Information in Medicine, City University, London EC1V 0HB
    Am J Physiol Endocrinol Metab 282:E992-1007. 2002
    ..Suppression of EGP matches the effect in the periphery...
  48. ncbi request reprint Evaluation of nonlinear regression approaches to estimation of insulin sensitivity by the minimal model with reference to Bayesian hierarchical analysis
    Ian F Godsland
    Endocrinology and Metabolic Medicine, Imperial College London, St Mary s Hospital, Mint Wing 2nd Floor, London W2 1PG, UK
    Am J Physiol Endocrinol Metab 291:E167-74. 2006
    ..S(I)(NLR) compared favorably with S(I)(BH) in the proportion of variance explained in known correlates of insulin sensitivity...
  49. ncbi request reprint Multicentric, randomized, controlled trial to evaluate blood glucose control by the model predictive control algorithm versus routine glucose management protocols in intensive care unit patients: Response to Ligtenberg et al
    Johannes Plank
    Diabetes Care 29:1987-8. 2006

Research Grants2

  1. Home testing of 24/7 closed-loop control in children and adolescents with type 1
    Roman Hovorka; Fiscal Year: 2009
    ..This will be preceded by evaluating 24/7 closed-loop control in compliant and non-compliant subjects in clinical research centre settings to collect data supporting regulatory submission for home testing. ..
  2. Home testing of 24/7 closed-loop control in children and adolescents with type 1
    Roman Hovorka; Fiscal Year: 2010
    ..This will be preceded by evaluating 24/7 closed-loop control in compliant and non-compliant subjects in clinical research centre settings to collect data supporting regulatory submission for home testing. ..