Control of blood glucose level for type 1 diabetes mellitus using improved Hovorka equations: Comparison between clinical and in-silico works

Background: Type 1 diabetes mellitus (T1DM) occurs due to inability of the body to produce sufficient amount of insulin to regulate blood glucose level (BGL) at normoglycemic range between 4.0 to 7.0 mmol/L. Thus, T1DM patients require doing self-monitoring blood glucose (SMBG) via finger pricks and depending on exogenous insulin injection to maintain their BGL which is very painful and exasperating. Ongoing works on artificial pancreas device nowadays focus primarily on a computer algorithm which is programmed into the controller device. This study aims to simulate so-called improved equations from the Hovorka model using actual patients’ data through in-silico works and compare its findings with the clinical works.

Methods: The study mainly focuses on computer simulation in MATLAB using improved Hovorka equations in order to control the BGL in T1DM. The improved equations can be found in three subsystems namely; glucose, insulin and insulin action subsystems. CHO intakes were varied during breakfast, lunch and dinner times for three consecutive days. Simulated data are compared with the actual patients’ data from the clinical works.

Results: Result revealed that when the patient took 36.0 g CHO during breakfast and lunch, the insulin administered was 0.1 U/min in order to maintain the blood glucose level (BGL) in the safe range after meal; while during dinner time, 0.083 U/min to 0.1 U/min of insulins were administered in order to regulate 45.0 g CHO taken during meal. The basal insulin was also injected at 0.066 U/min upon waking up time in the early morning. The BGL was able to remain at normal range after each meal during in-silico works compared to clinical works.

Conclusions: This study proved that the improved Hovorka equations via in-silico works can be employed to model the effect of meal disruptions on T1DM patients, as it demonstrated better control as compared to the clinical works.

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