A previous semi‐mechanistic model described changes in fasting serum insulin (FSI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) in patients with type 2 diabetic mellitus (T2DM) by modeling insulin sensitivity and β‐cell function. It was later suggested that change in body weight could affect insulin sensitivity, which this study evaluated in a population model to describe the disease progression of T2DM. Nonlinear mixed effects modeling was performed on data from 181 obese patients with newly diagnosed T2DM managed with diet and exercise for 67 weeks. Baseline β‐cell function and insulin sensitivity were 61% and 25% of normal, respectively. Management with diet and exercise (mean change in body weight = −4.1 kg) was associated with an increase of insulin sensitivity (30.1%) at the end of the study. Changes in insulin sensitivity were associated with a decrease of FPG (range, 7.8–7.3 mmol/L) and HbA1c (6.7–6.4%). Weight change as an effector on insulin sensitivity was successfully evaluated in a semi‐mechanistic population model.
The authors became aware of incorrect numbers and an incorrect figure in the original publication and as a result have included minor revisions to Table 1 and Figure 1, as outlined below and updated versions of Table 3 and Figure 2, as the conclusions are affected by changes in these.As a result of the updated Figure 2 and Table 3, the following conclusions can be drawn from the study and should be seen as the key findings:• The MPG based methods performed better than the FPG based methods -both in terms of mean prediction error and in terms of outcome predictions for comparative studies. • Two out of the three longitudinal models (Methods 4 and 5) performed better than the two steady-state methods (Methods 1 and 2) with respect to mean prediction error. • Only the longitudinal model based on MPG observations in combination with early HbA1c observations (Method 5) provided correct outcome predictions for all comparisons assessed. Furthermore, the authors note the following changes: Changes to Table 1: In the study by Rosenstock et al. (Diabetologia 51, 408-416 ( 2008)), HbA1c at baseline in the insulin glargine (comparator) arm should be 8.6% instead of 8.5%, and the number of subjects, n, should be 226 instead of 211. In the insulin detemir arm of the same study the number of subjects, n, should be 219 instead of 198. In the study by Raskin et al. (Diabetes Care 28, 260-265 (2005)), HbA1c at baseline in the insulin glargine (comparator) arm should be 9.9% instead of 9.7%.Changes to Table 3: Numerically small changes have been implemented in the table. These affect the overall mean prediction error and the overall absolute mean prediction error for Method 2, as well as the mean RMSE for all five methods.Changes to Figure 1: Minor changes appear in Figure 1 as a consequence of the changes in Table 3 (details not shown). Changes to Figure 2:As a result of the corrections, the performances of the five methods are more consistent than in the original figure. However, Method 5 remains superior to the other methods in predicting the outcome of the studies.
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