Roman Hovorka
Principal Research Associate
Department of Paediatrics
Research Interests
Mathematical modeling to support diagnosis and treatment of metabolic diseases
Our aim is to support the diagnosis and treatment of metabolic diseases using mathematical modeling techniques with particular focus on diabetes. We use existing and develop new methods to quantify insulin sensitivity, insulin secretion, and metabolic fluxes under steady and non-steady state conditions with deterministic and stochastic modeling techniques. Our interest extends to developing in silico populations to inform and complement clinical trialing.
We are developing and testing a prototype of artificial pancreas in collaboration with Professor Dunger and Dr Acerini (Paediatrics). The artificial pancreas consists of a subcutaneous glucose monitor, a control algorithm, and an insulin pump and has the potential to revolutionize the treatment of subjects with type 1 diabetes as short- and midterm availability of other closed-loop control options is unlikely. The work includes the development of a computer-based simulation environment, where we will evaluate and optimise the system performance prior to clinical investigations. We are developing in silico population of children and adolescents treated by insulin with an appropriate representation of between and within subject variability.
We are also interested in insulin titration in critically ill subjects. Our control algorithm is being tested in four intensive care units across Europe and a collaboration with medical devices company has been secured to explore commercial exploitation. We have also developed an in silico population of critically ill subjects at surgical and medical ICU to test glucose controllers.
Our research is funded by the JDRF, Diabetes UK, NIHR, NIH and FP7.
Selected Publications
Murphy HR, Elleri D, Allen JM, Harris J, Simmons D, Rayman G, Temple RC, Umpleby AM, Dunger DB, Haidar A, Nodale M, Wilinska ME, Hovorka R. (2012). Pathophysiology of postprandial hyperglycaemia in women with type 1 diabtes during pregnancy. Diabetologia, 55(2):282-93. PMID: 22080230.
Murphy HR, Kumareswaran K, Elleri D, Allen JM, Caldwell K, Biagioni M, Simmons D, Dunger DB, Nodale M, Wilinska ME, Amiel SA, Hovorka R. (2011). Safety and efficacy of 24-h closed-loop insulin delivery in well-controleed pregnany women with type 1 diabetes: a randomized crossover case series. Diabetes Care, 34(12):2527-9. PMID: 22011408. PMCID: PMC3220861.
Lunn DJ, Wei C, Hovorka R. (2011). Fitting dynamic models with forcing function: application to continuous glucose monitoring in insulin therapy. Stat Med, 30(18):2234-50. PMID: 21590789. PMCID: PMC3201840.
Elleri D, Dunger DB, Hovorka R. (2011). Closed-loop insulin delivery for treatment of type 1 diabetes. BMC Med, 2011 Nov 9;9:120. PMID: 22071283. PMCID: PMC3229449.
Hovorka R.(2011). Closed-loop insulin delivery: from bench to clinical practice. Nat Rev Endocrinol, 7(7):385-95. PMID: 21343892.
Hovorka R, Kumareswaran K, Harris J, Elleri D, Xing D, Kollman C, Nodale M, Murphy HR, Dunger DB, Amiel SA, Heller SR, Wilinska ME, Evans ML. (2011). Overnight closed loop insulin delivery (artificial pancreas) in adults with type 1 diabetes: crossover randomised controlled studies. BMJ, 342:d1855. doi: 10.1136/bmj.d1855. PMID: 21493665. PMCID: PMC3077739.
Elleri D, Allen JM, Nodale M, Wilinska ME, Mangat JS, Larsen AM, Acerini CL, Dunger DB, Hovorka R. (2011). Automated overnight closed-loop glucose control in young children with type 1 diabetes. Diabetes Technol Ther, 13(4):419-24. PMID: 21355719.
Murphy HR, Elleri D, Allen JM, Harris J, Simmons D, Rayman G, Temple R, Dunger DB, Haidar A, Nodale M, Wilinska ME, Hovorka R. (2011). Closed-loop insulin delivery during pregnancy complicated by type 1 diabetes. Diabetes Care, 34(2):406-11. PMID: 21216859. PMCID: PMC3024358.
Elleri D, Allen JM, Nodale M, Wilkinska ME, Acerini CL, Dunger DB, Hovorka R. (2010). Suspended insulin infusion during overnight closed-loop glucose control in children and adolescents with Type 1 diabetes. Diabet Med, 27(4):480-4. PMID: 20536523.
Hovorka R, Allen JM, Elleri D, Chassin LJ, Harris J, Xing D, Kollman C, Hovorka T, Larsen AM, Nodale M, De Palma A, Wilkinska ME, Acerini CL, Dunger DB. (2010). Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial. Lancet, 375(9716):743-51. PMID: 20138357.
Wilinska ME, Chassin LJ, Acerini CL, Allen JM, Dunger DB, Hovorka R. (2010). Stimulation environment to evaluate closed-loop insulin delivery systems in type 1 diabetes. J Diabetes Sci Technol, 4(1):132-44. PMID: 20167177. PMCID: PMC2825634.
Pennant ME, Bluck LJ, Marcovecchio LM, Salgin B, Hovorka R, Dunger DB. (2008).
Insulin administration and rate of glucose appearance in people with type 1 diabetes. Diabetes Care, 31(11):2183-7. PMID: 18650373. PMCID: PMC2571071.
Hovorka R, Jayatillake H, Rogatsky E, Tomuta V, Hovorka T, Stein DT. (2007).
Calculating glucose fluxes during meal tolerance test: a new computational approach. Am J Physiol Endocrinol Metab, 293(2):E610-9.
PMID: 17519281.