Development of a clinical type 1 diabetes metabolic system model and in silico simulation tool.

OBJECTIVES The goal of this study was to develop a system model of type 1 diabetes for the purpose of in silico simulation for the prediction of long-term glycemic control outcomes. METHODS The system model was created and identified on a physiological cohort of virtual type 1 diabetes patients (n = 40). Integral-based identification was used to develop (n = 40) insulin sensitivity profiles. RESULTS The n = 40 insulin sensitivity profiles provide a driving input for virtual patient trials using the models developed. The identified models have a median (90% range) absolute percentage error of 1.33% (0.08-7.20%). The median (90% range) absolute error was 0.12 mmol/liter (0.01-0.56 mmol/liter). The model and integral-based identification of SI captured all patient dynamics with low error, which would lead to more physiological behavior simulation. CONCLUSIONS A simulation tool incorporating n = 40 virtual patient data sets to predict long-term glycemic control outcomes from clinical interventions was developed based on a physiological type 1 diabetes metabolic system model. The overall goal is to utilize this model and insulin sensitivity profiles to develop and optimize self-monitoring blood glucose and multiple daily injection therapy.