On hyperglicemic glucose basal levels in Type 1 Diabetes Mellitus from dynamic analysis.

ABSTRACT

Compartmental-Physiological Models (CPM's) have been used to derive feedback controllers for the glucose regulation in Diabetes Mellitus (DM). Despite these important advances, there are two criticisms about the use of the CPM's in DM (i) Can this class of model reproduce severe basal glucose levels (e.g., larger than 300 mg/dl)? and (ii) Does a CPM reproduce a distinct glucose level as its parameters change or is it unique even if its parameters change? This contribution aims these criticisms from the study of the parametric sensitivity of a CPM. The results exploit the analysis of the dynamic properties of the chosen CPM and permit to show that such model can reproduce distinct severe basal levels by modifying the values of the metabolic parameters, which agree with expectations on a realistic model. Mainly, the chosen CPM has been selected due to the following two reasons. (i) It includes the main organs related to the glucose metabolism in Type 1 Diabetes Mellitus (T1DM); as, for example, the liver, brain and kidney. (ii) It models metabolic phenomena as, for instance, the counter-regulatory effects by glucagon and the hepatic glucose uptake/production. Additionally, the chosen model has been recently used to design feedback controllers for the glucose regulation with very promissory results.