Empirical Representation of Blood Glucose Variability in a Compartmental Model

Abstract

Eating and exercise behaviors have an important effect on glycemic out-comes in type 1 diabetes, yet these influences are difficult to assess in real-life set-tings. While existing mathematical models faithfully represent the dynamic relation-ships of (i) oral carbohydrate ingestion and (ii) glucose and insulin transport/action in various compartments of the body, accurate models of meal and exercise behav-iors are needed to realistically capture the wide excursions of blood glucose ob-served in the field, and this has been a bottleneck in preclinical in silico evaluation of advanced systems including the artificial pancreas. This work presents a method of using continuous glucose monitoring and insulin pump data to extract a BG vari-ability signature represented by oral carbohydrate net effect, which can be " fed " back into the mathematical model to (i) reproduce the original BG time series from Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the sponsors. 1 2 S. D. Patek; D. Lv, et al. the original record of insulin delivery and (ii) be used to approximate the effect of a modified schedule of insulin delivery. We provide details of the basic method and illustrate the approach using both the Virginia / Padova Type 1 Simulator and human subject data collected in a field study.