Bio-behavioral control, glucose variability, and hypoglycemia-associated autonomic failure in type 1 diabetes (T1DM).
In this paper we present a mathematical model and a computer simulation of the relationship between behavioral control of Type 1 diabetes (T1DM), blood glucose (BG) variability, and hypoglycemia-associated autonomic failure (HAAF). A stochastic behavioral self-control process was coupled with a dynamical system simulation of the dampening effect of counterregulation on BG oscillations. The resulting bio-behavioral control system was able to reproduce characteristics of hypoglycemic events in the field, such as temporal clustering of hypoglycemic episodes associated with HAAF, and occurrence of severe hypoglycemia as a result of periods of HAAF augmented by increased BG variability.
Breton
Marc D
MD
School of Medicine, University of Virginia, USA.
Farhy
Leon S
LS
Penberthy
Jennifer K
JK
Kovatchev
Boris P
BP
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003198:Computer Simulation; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008954:Models, Biological; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome
D001786:Blood Glucose