Patient decision-making of CGM sensor driven insulin therapies in type 1 diabetes: In silico assessment.
Annu Int Conf IEEE Eng Med Biol Soc
; 2015: 2363-6, 2015.
Article
en En
| MEDLINE
| ID: mdl-26736768
In type 1 diabetes (T1D) therapy, continuous glucose monitoring (CGM) sensors, which provide glucose concentration in the subcutis every 1-5 min for 7 consecutive days, should allow in principle a more efficient insulin dosing than that based on the conventional 3-4 self-monitoring of blood glucose (SMBG) measurements per day. However, CGM, at variance with SMBG, is still not approved for insulin dosing in T1D management because regulatory agencies, e.g. FDA, are looking for more factual evidence on its safety. An in silico assessment of SMBG- vs CGM-driven insulin therapy can be a first step. Here we present a simulation model of T1D patient decision-making obtained by interconnecting models of glucose-insulin dynamics, SMBG and CGM measurement errors, carbohydrates-counting errors, insulin boluses time variability and forgetfulness, and subcutaneous insulin pump delivery. Inter- and intra- patient variability of model parameters are considered. The T1D patient decision-making model allows to run realistic multi-day simulations scenarios in a population of virtual subjects. We present the first results of simulations run in 20 virtual subjects over a 7-day period, which demonstrates that additional information brought by CGM (trend and hypo/hyperglycemic warnings) with respect to SMBG produces a statistically significant increment (about of 9%) of time spent by the patient in the euglycemic range (70-180 mg/dl).
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Glucemia
/
Diabetes Mellitus Tipo 1
/
Insulina
/
Monitoreo Fisiológico
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Annu Int Conf IEEE Eng Med Biol Soc
Año:
2015
Tipo del documento:
Article
Pais de publicación:
Estados Unidos