In Silico Simulation of Long-Term Type 1 Diabetes Glycemic Control Treatment Outcomes

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Journal Article
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University of Canterbury. Mechanical Engineering.
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Date
2008
Authors
Wong, X.W.
Chase, Geoff
Hann, C.E.
Lotz, T.
Lin, J.
Le Compte, A.J.
Shaw, Geoff
Abstract

Objectives: The goals of this study were to develop (1) a safe and effective protocol for the clinical control of type 1 diabetes using conventional self-monitoring blood glucose (SMBG) measurements and multiple daily injections with insulin analogues, and (2) an in silico simulation tool of type 1 diabetes to predict long-term glycemic control outcomes of clinical interventions. Methods: The virtual patient method was used to develop a simulation tool for type 1 diabetes using data from a type 1 diabetes patient cohort (n = 40). The tool was used to test the adaptive protocol (AC) and a conventional intensive insulin therapy (CC) against results from a representative control cohort. Optimal and suboptimal basal insulin replacements were evaluated as a function of SMBG frequency in conjunction with the (AC and CC) prandial control protocols. Results: In long-term glycemic control, the AC protocol significantly decreased hemoglobin A1c in conditions of suboptimal basal insulin replacement for SMBG frequencies =6/day, and reduced the occurrence of mild and severe hypoglycemia by 86–100% over controls, over all SMBG frequencies in conditions of optimal basal insulin.

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Invited journal symposium paper
Citation
Wong, X.W., Chase, J.G., Hann, C.E., Lotz, T., Lin, J., Le Compte, A.J., Shaw, G.M. (2008) In Silico Simulation of Long-Term Type 1 Diabetes Glycemic Control Treatment Outcomes. Journal of Diabetes Science and Technology, 2(3), pp. 436-449.
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