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 EU FP6, the JDRF and EFSD.
Selected Publications
Elleri D, Acerini CL, Allen JM, Larsen AM, Wilinska ME, Dunger DB, Hovorka R. Effect of delay on measurement of blood glucose levels in young subjects with type 1 diabetes. Diabetes Res Clin Pract. 2009 Jul 28. Abstract
Kumareswaran K, Evans ML, Hovorka R. Artificial pancreas: an emerging approach to treat Type 1 diabetes. Expert Rev Med Devices. 2009 Jul;6(4):401-10. Review. Abstract
Blaha J, Kopecky P, Matias M, Hovorka R, Kunstyr J, Kotulak T, Lips M, Rubes D, Stritesky M, Lindner J, Semrad M, Haluzik M. Comparison of three protocols for tight glycemic control in cardiac surgery patients. Diabetes Care. 2009 May;32(5):757-61. Epub 2009 Feb 5. Abstract
Salgin B, Marcovecchio ML, Humphreys SM, Hill N, Chassin LJ, Lunn DJ, Hovorka R, Dunger DB. Effects of prolonged fasting and sustained lipolysis on insulin secretion and insulin sensitivity in normal subjects. Am J Physiol Endocrinol Metab. 2009 Mar;296(3):E454-61. Epub 2008 Dec 23. Abstract
Hovorka R, Chassin LJ, Ellmerer M, Plank J, Wilinska ME. A simulation model of glucose regulation in the critically ill. Physiol Meas. 2008 Aug;29(8):959-78. Epub 2008 Jul 18. Abstract
Hovorka R. The future of continuous glucose monitoring: closed loop. Curr Diabetes Rev. 2008 Aug;4(3):269-79. Abstract
Cordingley JJ, Vlasselaers D, Dormand NC, Wouters PJ, Squire SD, Chassin LJ, Wilinska ME, Morgan CJ, Hovorka R, Van den Berghe G. Intensive insulin therapy: enhanced Model Predictive Control algorithm versus standard care.
Intensive Care Med. 2008 Jul 26. [Epub ahead of print] Abstract
Pennant ME, Bluck LJ, Marcovecchio LM, Salgin B, Hovorka R, Dunger DB.
Insulin administration and rate of glucose appearance in people with type 1 diabetes. Diabetes Care. 2008 Jul 23. [Epub ahead of print] Abstract
Pachler C, Plank J, Weinhandl H, Chassin LJ, Wilinska ME, Kulnik R, Kaufmann P, Smolle KH, Pilger E, Pieber TR, Ellmerer M, Hovorka R. Tight glycaemic control by an automated algorithm with time-variant sampling in medical ICU patients. Intensive Care Med. Jul;34(7):1224-30. Epub 2008 Feb 23. ; Absract
Hovorka R, Kremen J, Blaha J, Matias M, Anderlova K, Bosanska L, Roubicek T, Wilinska ME, Chassin LJ, Svacina S, Haluzik M. 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.
J Clin Endocrinol Metab. 2007 Aug;92(8):2960-4. Epub 2007 Jun 5. Abstract
Hovorka R, Jayatillake H, Rogatsky E, Tomuta V, Hovorka T, Stein DT.
Calculating glucose fluxes during meal tolerance test: a new computational approach. Am J Physiol Endocrinol Metab. 2007 Aug;293(2):E610-9. Epub 2007 May 22. Abstract
R. Hovorka, M. E. Wilinska, L. J. Chassin, and D. B. Dunger. Roadmap to the artificial pancreas. Diabetes Res Clin Pract. 74 Suppl 2:S178-S182, 2006. Abstract
J. Plank, J. Blaha, J. Cordingley, M. E. Wilinska, L. J. Chassin, C. Morgan, S. Squire, M. Haluzik, J. Kremen, S. Svacina, W. Toller, A. Plasnik, M. Ellmerer, R. Hovorka, and T. R. Pieber. 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. Diabetes Care 29 (2):271-276, 2006. Abstract