A model for multiple subcutaneous insulin injections developed from
individual diabetic patient data.
Puckett, Wanda R., Edwin N. Lightfoot.
Chemical Engineering Department, 1415 Johnson Drive, University of
Wisconsin - Madison, Madison, WI 53706
APStracts 2:0185E, 1995.
Many diabetic patients taking multiple subcutaneous insulin injections
cannot adjust their dosage appropriately to maintain blood glucose
within a normal range. It is hard to predict how dosage changes and
physiological fluctuations affect insulin levels and subsequently
glucose control. To examine these issues, we have developed a model
representing the link between dosage and blood insulin levels. Our
model adequately predicts insulin concentrations for individual
patients and could be incorporated into an overall glucose-insulin
representation. More importantly, parameter and sensitivity analysis
results highlight insulin kinetic features that are difficult to
isolate in a clinical setting and that may significantly influence
glucose dynamics. For example, large inter-patient variation,
measured quantitatively by model parameters, emphasizes the need for
individualized design of insulin regimens. Intra-patient variations
are also large in some patients. Improved control for these patients
may only be possible through more frequent sampling and control
action. The sensitivity coefficient for absorption suggests a
significant overlapping injection effect which is not considered in
present patient management strategies.
Received 4 March 1993; accepted in final form 28 June 1995.
APS Manuscript Number E80-3.
Article publication pending Am. J. Physiol. (Endocrinol. Metab.).
ISSN 1080-4757 Copyright 1995 The American Physiological Society.
Published in APStracts on 23 September 1995.