Cargando…

Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon

The Glucose-Insulin-Glucagon nonlinear model accurately describes how the body responds to exogenously supplied insulin and glucagon in patients affected by Type I diabetes. Based on this model, we design infusion rates of either insulin (monotherapy) or insulin and glucagon (dual therapy) that can...

Descripción completa

Detalles Bibliográficos
Autores principales: Shirin, Afroza, Della Rossa, Fabio, Klickstein, Isaac, Russell, John, Sorrentino, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426249/
https://www.ncbi.nlm.nih.gov/pubmed/30893335
http://dx.doi.org/10.1371/journal.pone.0213665
_version_ 1783404977962614784
author Shirin, Afroza
Della Rossa, Fabio
Klickstein, Isaac
Russell, John
Sorrentino, Francesco
author_facet Shirin, Afroza
Della Rossa, Fabio
Klickstein, Isaac
Russell, John
Sorrentino, Francesco
author_sort Shirin, Afroza
collection PubMed
description The Glucose-Insulin-Glucagon nonlinear model accurately describes how the body responds to exogenously supplied insulin and glucagon in patients affected by Type I diabetes. Based on this model, we design infusion rates of either insulin (monotherapy) or insulin and glucagon (dual therapy) that can optimally maintain the blood glucose level within desired limits after consumption of a meal and prevent the onset of both hypoglycemia and hyperglycemia. This problem is formulated as a nonlinear optimal control problem, which we solve using the numerical optimal control package [Image: see text] . Interestingly, in the case of monotherapy, we find the optimal solution is close to the standard method of insulin based glucose regulation, which is to assume a variable amount of insulin half an hour before each meal. We also find that the optimal dual therapy (that uses both insulin and glucagon) is better able to regulate glucose as compared to using insulin alone. We also propose an ad-hoc rule for both the dosage and the time of delivery of insulin and glucagon.
format Online
Article
Text
id pubmed-6426249
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-64262492019-04-02 Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon Shirin, Afroza Della Rossa, Fabio Klickstein, Isaac Russell, John Sorrentino, Francesco PLoS One Research Article The Glucose-Insulin-Glucagon nonlinear model accurately describes how the body responds to exogenously supplied insulin and glucagon in patients affected by Type I diabetes. Based on this model, we design infusion rates of either insulin (monotherapy) or insulin and glucagon (dual therapy) that can optimally maintain the blood glucose level within desired limits after consumption of a meal and prevent the onset of both hypoglycemia and hyperglycemia. This problem is formulated as a nonlinear optimal control problem, which we solve using the numerical optimal control package [Image: see text] . Interestingly, in the case of monotherapy, we find the optimal solution is close to the standard method of insulin based glucose regulation, which is to assume a variable amount of insulin half an hour before each meal. We also find that the optimal dual therapy (that uses both insulin and glucagon) is better able to regulate glucose as compared to using insulin alone. We also propose an ad-hoc rule for both the dosage and the time of delivery of insulin and glucagon. Public Library of Science 2019-03-20 /pmc/articles/PMC6426249/ /pubmed/30893335 http://dx.doi.org/10.1371/journal.pone.0213665 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Shirin, Afroza
Della Rossa, Fabio
Klickstein, Isaac
Russell, John
Sorrentino, Francesco
Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon
title Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon
title_full Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon
title_fullStr Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon
title_full_unstemmed Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon
title_short Optimal regulation of blood glucose level in Type I diabetes using insulin and glucagon
title_sort optimal regulation of blood glucose level in type i diabetes using insulin and glucagon
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426249/
https://www.ncbi.nlm.nih.gov/pubmed/30893335
http://dx.doi.org/10.1371/journal.pone.0213665
work_keys_str_mv AT shirinafroza optimalregulationofbloodglucoselevelintypeidiabetesusinginsulinandglucagon
AT dellarossafabio optimalregulationofbloodglucoselevelintypeidiabetesusinginsulinandglucagon
AT klicksteinisaac optimalregulationofbloodglucoselevelintypeidiabetesusinginsulinandglucagon
AT russelljohn optimalregulationofbloodglucoselevelintypeidiabetesusinginsulinandglucagon
AT sorrentinofrancesco optimalregulationofbloodglucoselevelintypeidiabetesusinginsulinandglucagon