Identification of diurnal patterns in insulin action from measured CGM data for patients with T1DM

Abstract

We propose a method to identify diurnal changes in insulin action in patients suffering from type 1 diabetes mellitus (T1DM) based on data recorded by continuous glucose monitoring systems (CGMS). In order to do so the data is fitted using a continuous time transfer function including time dependent terms. The identified values for the insulin needs per gram of carbohydrate were compared with the patientspecific carbohydrate-to-insulin-ratios used for the calculation of the bolus insulin needs. A good agreement between the identified parameters and values determined by diabetologists were found. Furthermore, the diurnal variations in insulin action (as inferred from the changes in the patient-specific carbohydrate-to-insulin-ratios) could be reproduced. The identified models, including the diurnal changes in insulin action and the information on the intra-patient variability, have the potential to be used in future studies for managing the blood glucose level of patients, e.g. in a smart bolus calculator.

Analyzing the Potential of Advanced Insulin Dosing Strategies in Patients With Type 2 Diabetes: Results From a Hybrid In Silico Study

“…In this study CIR and ISF are tuned patient-specifically and daytime-specifically using the adaptive bolus calculator (ABC) method. 42,43 The ABC uses a simple mathematical model to identify the correlation between insulin amounts and BG values, as well as between carbohydrate amounts and BG values from data and derives estimates of CIR and ISF from those mathematical descriptions. The resulting estimates for CIR and ISF are further used in the standard bolus calculator formula.…”