Simulation Models for In-Silico Evaluation of Closed-Loop Insulin Delivery Systems in Type 1 Diabetes

Abstract

This chapter presents simulation models created to support the development of closed-loop insulin delivery systems in type 1 diabetes. Such models, also known as ‘virtual patient’ models, represent an input-output relationship between insulin delivery and other external inputs such as meals or exercise, and the resulting glucose response. It is argued that these simulation models are an essential prerequisite for an accelerated development of the artificial pancreas systems in various populations of type 1 diabetes ranging from children to adults and pregnancies. The present review provides a general introduction to the models of glucose regulation in type 1 diabetes and then proceeds to discussing the individual submodels of glucose kinetics and insulin action, subcutaneous insulin kinetics, subcutaneous glucose kinetics, glucose absorption from the gut, and the exercise effect on the glucose kinetics. Finally, several important virtual-patient models used for in silico testing of glucose controllers are reviewed.