Abstract
Current mathematical models of postprandial glucose metabolism in people with normal and impaired glucose tolerance rely on insulin measurements and are therefore not applicable in clinical practice. This research aims to develop a model that only requires glucose data for parameter estimation while also providing useful information on insulin sensitivity, insulin dynamics and the meal-related glucose appearance (GA). The proposed glucose-only model (GOM) is based on the oral minimal model (OMM) of glucose dynamics and substitutes the insulin dynamics with a novel function dependant on glucose levels and GA. A Bayesian method and glucose data from 22 subjects with normal glucose tolerance are utilised for parameter estimation. To validate the results of the GOM, a comparison to the results of the OMM, obtained by using glucose and insulin data from the same subjects is carried out. The proposed GOM describes the glucose dynamics with comparable precision to the OMM with an RMSE of 5.1 ± 2.3 mg/dL and 5.3 ± 2.4 mg/dL, respectively and contains a parameter that is significantly correlated to the insulin sensitivity estimated by the OMM (r = 0.7) Furthermore, the dynamic properties of the time profiles of GA and insulin dynamics inferred by the GOM show high similarity to the corresponding results of the OMM. The proposed GOM can be used to extract useful physiological information on glucose metabolism in subjects with normal glucose tolerance. The model can be further developed for clinical applications to patients with impaired glucose tolerance under the use of continuous glucose monitoring data.
Highlights
Mathematical models are a powerful tool to describe and assess the body’s response to food intake in people with normal glucose tolerance as well as prediabetes and type 2 diabetes mellitus (T2DM)
The application of any of the proposed models in clinical practice, that is, for the diagnosis or treatment of individuals with impaired glucose tolerance, has yet to be seen. This lack of clinical application can mainly be attributed to the high cost, unreliability and dependence on venous access of insulin measurements, prohibiting widespread clinical or ambulatory insulin data collection.[5,6]
The parameter estimation of the glucose-only model (GOM) was carried out in all 66 recorded responses (22 subjects with 3 responses each), and the individual results are provided in section 2.1 of the supplementary information
Summary
Mathematical models are a powerful tool to describe and assess the body’s response to food intake in people with normal glucose tolerance as well as prediabetes and type 2 diabetes mellitus (T2DM). These models typically utilise glucose and insulin data after an oral glucose intake for parameter estimation They have contributed significantly to the understanding of the metabolic processes responsible for the loss of glycaemic control.[1,2,3,4] Despite this success, the application of any of the proposed models in clinical practice, that is, for the diagnosis or treatment of individuals with impaired glucose tolerance, has yet to be seen. This research aims to develop a model that only requires glucose data for parameter estimation while providing useful information on insulin sensitivity, insulin dynamics and the meal-related glucose appearance (GA)
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