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Modeling as a Tool to Support Self-Management of Type 1 Diabetes
Linköping University, Department of Biomedical Engineering. Linköping University, Faculty of Health Sciences.
2013 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Type 1 diabetes (T1D) is an auto-immune disease characterized by insulin-deficiency. Insulin is a metabolic hormone that is involved in lowering blood glucose (BG) levels in order to control BG level to a tight range. In T1D this glycemic control is lost, causing chronic hyperglycemia (excess glucose in blood stream). Chronic hyperglycemia damages vital tissues. Therefore, glycemic control must be restored.

A common therapy for restoring glycemic control is intensive insulin therapy, where the missing insulin is replaced with regular insulin injections. When dosing this compensatory insulin many factors that affect glucose metabolism must be considered. Linkura is a company that has developed tools for monitoring the most important factors, which are meals and exercise. In the Linkura meal and exercise tools, the nutrition content in meals and the calorie consumption during exercise are estimated. Another tool designed to aid control of BG is the bolus calculator. Bolus calculators use input of BG level, carbohydrate intake, and insulin history to estimate insulin need. The accuracy of these insulin bolus calculations suffer from two problems. First, errors occur when users inaccurately estimate the carbohydrate content in meals. Second, exercise is not included in bolus calculations. To reduce these problems, it was suggested that the Linkura web tools could be utilized in combination with a bolus calculator.

For this purpose, a bolus calculator was developed. The bolus calculator was based on existing models that utilize clinical parameters to relate changes in BG levels to meals, insulin, and exercise stimulations. The bolus calculator was evaluated using data collected from Linkura's web tools. The collected data showed some inconsistencies which cannot be explained by any model.  The performance of the bolus calculator in predicting BG levels using general equations to derive the clinical parameters was inadequate. Performance was increased by adopting an update-algorithm where the clinical parameters were updated daily using previous data. Still, better model performance is prefered for use in a bolus calculator.  

The results show potential in developing bolus calculator tools combined with the Linkura tools. For such bolus calculator, further evaluation on modeling long-term exercise and additional safety features minimizing risk of hypoglycemia are required.

Place, publisher, year, edition, pages
2013. , 72 p.
Keyword [en]
Type 1 diabetes, insulin dose estimation, bolus calculator, mathematical modeling, modeling insulin need, diabetes models, glucose metabolism models, physical exercise models, carbohydrate counting, decision-support systems
National Category
Bioinformatics and Systems Biology
URN: urn:nbn:se:liu:diva-88499ISRN: LiTH-IMT/MI30-A-EX--12/508--SEOAI: diva2:604414
External cooperation
Linkura, Wolfram Mathcore
Subject / course
Medical Informatics
2012-12-17, IMT1, Linköpings universitet, Linköping, 15:30 (Swedish)
Available from: 2013-02-11 Created: 2013-02-11 Last updated: 2013-02-11Bibliographically approved

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Department of Biomedical EngineeringFaculty of Health Sciences
Bioinformatics and Systems Biology

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