| Title |
Modelling the effect of insulin on the disposal of meal-attributable glucose in type 1 diabetes
|
|---|---|
| Published in |
Medical & Biological Engineering & Computing, May 2016
|
| DOI | 10.1007/s11517-016-1509-6 |
| Pubmed ID | |
| Authors |
Fernando García-García, Roman Hovorka, Malgorzata E. Wilinska, Daniela Elleri, M. Elena Hernando |
| Abstract |
The management of postprandial glucose excursions in type 1 diabetes has a major impact on overall glycaemic control. In this work, we propose and evaluate various mechanistic models to characterize the disposal of meal-attributable glucose. Sixteen young volunteers with type 1 diabetes were subject to a variable-target clamp which replicated glucose profiles observed after a high-glycaemic-load ([Formula: see text]) or a low-glycaemic-load ([Formula: see text]) evening meal. [6,6-[Formula: see text]] and [U-[Formula: see text];1,2,3,4,5,6,6-[Formula: see text]] glucose tracers were infused to, respectively, mimic: (a) the expected post-meal suppression of endogenous glucose production and (b) the appearance of glucose due to a standard meal. Six compartmental models (all a priori identifiable) were proposed to investigate the remote effect of circulating plasma insulin on the disposal of those glucose tracers from the non-accessible compartments, representing e.g. interstitium. An iterative population-based parameter fitting was employed. Models were evaluated attending to physiological plausibility, posterior identifiability of their parameter estimates, accuracy-via weighted fitting residuals-and information criteria (i.e. parsimony). The most plausible model, best representing our experimental data, comprised: (1) a remote effect x of insulin active above a threshold [Formula: see text] = 1.74 (0.81-2.50) [Formula: see text] min[Formula: see text] [median (inter-quartile range)], with parameter [Formula: see text] having a satisfactory support: coefficient of variation CV = 42.33 (31.34-65.34) %, and (2) steady-state conditions at the onset of the experiment ([Formula: see text]) for the compartment representing the remote effect, but not for the masses of the tracer that mimicked endogenous glucose production. Consequently, our mechanistic model suggests non-homogeneous changes in the disposal rates for meal-attributable glucose in relation to plasma insulin. The model can be applied to the in silico simulation of meals for the optimization of postprandial insulin infusion regimes in type 1 diabetes. |
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 52 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 19% |
| Student > Ph. D. Student | 6 | 12% |
| Student > Postgraduate | 5 | 10% |
| Student > Doctoral Student | 4 | 8% |
| Student > Bachelor | 4 | 8% |
| Other | 11 | 21% |
| Unknown | 12 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 12 | 23% |
| Engineering | 8 | 15% |
| Nursing and Health Professions | 5 | 10% |
| Mathematics | 3 | 6% |
| Computer Science | 2 | 4% |
| Other | 8 | 15% |
| Unknown | 14 | 27% |
Attention Score in Context
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#17,286,645
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Outputs from Medical & Biological Engineering & Computing
#1,677
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Outputs of similar age from Medical & Biological Engineering & Computing
#16
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