Document Detail


The impact of non-model-related variability on blood glucose prediction.
MedLine Citation:
PMID:  17705692     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Physiological models are frequently used to predict blood glucose values from insulin and meal data of people with diabetes. Obviously, errors in the input data used result in prediction errors. A more complex problem is that no model may include all factors influencing the blood glucose level in any given situation. We have analyzed the influence of five parameters on prediction accuracy with respect to the time horizon. METHODS: A physiological model, consisting of an insulin model, a meal model, and a glucose metabolism model in combination with a Monte Carlo simulation, was used for this investigation. It was used to examine the change in blood glucose following the intake of carbohydrate and insulin. The intra-individual variability, which was studied, included pharmacokinetic variability of insulin aspart and estimation error of carbohydrate intake, as well as the accuracy of blood glucose meters and insulin pens. RESULTS: Simulations showed how the coefficient of variance for the different model compartments changes over time. For average people with diabetes the inaccuracies of blood glucose meters and carbohydrate estimates contribute to more than half of the variance. CONCLUSION: We showed how blood glucose prediction is severely affected by the inaccuracy in the input variables. Metabolic fluctuations, causing variability in insulin dynamics, also display important effects, but these are difficult to change. The inaccuracy of carbohydrate counting and the use of blood glucose meters appear to be the two main sources of error, which can be reduced through better patient education.
Authors:
Jonas Kildegaard; Jette Randløv; Jens Ulrik Poulsen; Ole K Hejlesen
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes technology & therapeutics     Volume:  9     ISSN:  1520-9156     ISO Abbreviation:  Diabetes Technol. Ther.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-20     Completed Date:  2007-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889084     Medline TA:  Diabetes Technol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  363-71     Citation Subset:  IM    
Affiliation:
Department of Health Science and Technology, University of Aalborg, Aalborg, Denmark. mail@jonaskildegaard.com
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MeSH Terms
Descriptor/Qualifier:
Blood Glucose / analysis,  metabolism*
Computer Simulation
Eating / physiology
Humans
Insulin / secretion
Models, Biological
Monte Carlo Method
Predictive Value of Tests
Chemical
Reg. No./Substance:
0/Blood Glucose; 11061-68-0/Insulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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