Glucose–insulin regulation model with subcutaneous insulin injection and evaluation using diabetic inpatients data

• Published in: Computer methods and programs in biomedicine Vol. 111; no. 2; pp. 347 - 356
• Main Authors: Wu, Zimei, Chui, Chee Kong, Hong, Geok Soon, Khoo, Eric, Chang, Stephen
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ireland Ltd 01.08.2013; Elsevier
• Subjects: Absorption; Adult; Aged; Algorithms; Biological and medical sciences; Blood Glucose - analysis; Blood Glucose Self-Monitoring - instrumentation; Blood Glucose Self-Monitoring - methods; Computer Simulation; Diabetes; Diabetes Mellitus - blood; Diabetes Mellitus - drug therapy; Diabetes. Impaired glucose tolerance; Drug Monitoring - methods; Endocrine pancreas. Apud cells (diseases); Endocrinology; Endocrinopathies; Glucose–insulin model; Hormones. Endocrine system; Humans; Injections, Subcutaneous; Inpatients; Insulin - administration & dosage; Insulin - pharmacokinetics; Insulin Infusion Systems; Internal Medicine; Investigative techniques, diagnostic techniques (general aspects); Least-Squares Analysis; Linear Models; Male; Medical sciences; Middle Aged; Model evaluation; Models, Biological; Oscillometry - methods; Other; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Pharmacology. Drug treatments; Subcutaneously-injected insulin; Young Adult; Model evaluation; Diabetes; Glucose–insulin model; Subcutaneously-injected insulin; Endocrinopathy; Closed loop; Computer simulation; Meal; Anonymity; Metabolic diseases; Glucose; Insulin; Modeling; Least squares method; Subcutaneous administration; Physiology; Glucose―insulin model; Non linear effect; Medical application; Glycemia
• ISSN: 0169-2607; 1872-7565; 1872-7565
• DOI: 10.1016/j.cmpb.2013.05.001

Closed-loop insulin delivery systems often implement glucose measurement and insulin administration in the subcutis. However some existing models for glucose–insulin system ignored the dynamics of subcutaneous glucose and subcutaneously-injected insulin. This paper reports a two-compartment model that includes glucose and insulin dynamics in subcutis, and its evaluation using patient data. Clinical information such as glucose level, insulin dosage, insulin injection time and meals of anonymous diabetes inpatients was collected. Measured glucose level of the diabetic inpatients agrees with that of computer simulation. Due to the lack of glucose–insulin model with subcutaneously-injected insulin for type 2 diabetic patients, our model was compared with existing model for type 1 subjects. The new glucose–insulin model can mimic dynamics of glucose and insulin under the disturbance of insulin injections and meals. Model parameters were estimated using nonlinear least square method and their effect on pathology and physiology of diabetes were analyzed.