Validation of a model of glucagon action including glucagon receptor dynamics under consecutive doses in low and high-carb diets

Abstract

Accurate mathematical models are needed to simulate and validate dual-hormone control algorithms for Artificial pancreas systems. Glucagon receptors are a key component for glucagon to have effect on glucose. However, they are not usually taken into consideration in the development of models for type 1 diabetes (T1D). In previous work, a model proposal integrating glucagon receptor dynamics into endogenous glucose production (EGP) was successfully validated under single glucagon boluses. In this work, this model is further validated using a dataset of clinical data where two glucagon doses (100 and 500 µg) are consecutively administered to 10 patients with T1D in two different settings: low and high-carb diets (total of 20 datasets). The model performance is compared to three other EGP models from literature under different identification criteria. The receptors model achieved the lowest root mean squared error regardless of the diet and the individualization method.