T1DM glycemic control: Effects of mixed meals and intra-patient variability in continuous insulin treatments

Designing an algorithm for the glycemic control in T1DM patients is the main goal of many researchers in the artificial pancreas study. In order to achieve this goal, models of the glucose-insulin system were developed. This study reports on the development of a simulator by the working group based in UVa simulator and manifest the importance of the effects of mixed meals and intra-patient variability in the performance of treatments based in continuous subcutaneous insulin infusion (CSII). The simulator incorporates a mixed meals library and contemplates the variation of the insulin sensitivity of the patients. In silico tests were performed over a 10 adult patient cohort in different scenarios under open and closed loop CSII treatments. Results illustrate the changes in the treatment performance, underlying the importance of considering the composition and the intra-variation of the patients when developing and validating glycemic control strategies.