Clinical validation of a new control-oriented model of insulin and glucose dynamics in subjects with type I diabetes
Clinical validation of a new control-oriented model of insulin and glucose dynamics in subjects with type I diabetes
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DOI：
10.1089/dia.2006.0030
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发表时间：
2007-08-01
影响因子：
5.4
通讯作者：
Massi-Benedetti, Massimo
中科院分区：
文献类型：
--
作者：
Fabietti, Pier Giorgio;Canonico, Valentina;Massi-Benedetti, Massimo
背景资料：人工胰腺的开发需要糖尿病病理生理学的准确表示，以创建用于自动胰岛素输注调节的有效且安全的控制系统。本研究的目的是评估先前开发的数学模型的胰岛素和葡萄糖代谢在I型糖尿病和评价其有效性的发展和测试的控制algorithm.Methods：基于已经存在的“最小模型”的一个新的数学模型的葡萄糖和胰岛素的子模型组成的开发。葡萄糖模型包括外周摄取、肝脏摄取和释放以及肾脏清除的表示。胰岛素模型描述了皮下或静脉注射外源性胰岛素的动力学。胰岛素敏感性的估计允许模型针对每个受试者个性化参数。来自两个不同临床试验的数据集在这里用于通过模拟研究进行模型验证。第一组采用皮下胰岛素注射，第二组采用静脉胰岛素注射。模拟和真实的血糖曲线（G（rms））和克拉克误差网格分析之间的均方根误差被用来评估系统efficiency.Results：从我们的研究结果表明，该模型的能力，即使在不同的实验条件下，在识别个人的特点。这是反映了一个有效的模拟G（均方根），克拉克误差网格分析的临床可接受性，在两个临床dataseres.Conclusions：模拟结果证实了该模型的能力，忠实地代表葡萄糖-胰岛素的关系，在不同的情况下，在I型糖尿病。
Background: The development of an artificial pancreas requires an accurate representation of diabetes pathophysiology to create effective and safe control systems for automatic insulin infusion regulation. The aim of the present study is the assessment of a previously developed mathematical model of insulin and glucose metabolism in type I diabetes and the evaluation of its effectiveness for the development and testing of control algorithms.Methods: Based on the already existing "minimal model" a new mathematical model was developed composed of glucose and insulin submodels. The glucose model includes the representation of peripheral uptake, hepatic uptake and release, and renal clearance. The insulin model describes the kinetics of exogenous insulin injected either subcutaneously or intravenously. The estimation of insulin sensitivity allows the model to personalize parameters to each subject. Data sets from two different clinical trials were used here for model validation through simulation studies. The first set had subcutaneous insulin injection, while the second set had intravenous insulin injection. The root mean square error between simulated and real blood glucose profiles (G(rms)) and the Clarke error grid analysis were used to evaluate the system efficacy.Results: Results from our study demonstrated the model's capability in identifying individual characteristics even under different experimental conditions. This was reflected by an effective simulation as indicated by G(rms), and clinical acceptability by the Clarke error grid analysis, in both clinical data series.Conclusions: Simulation results confirmed the capacity of the model to faithfully represent the glucose-insulin relationship in type I diabetes in different circumstances.