Mathematical models of diabetes progression

Andrea De Gaetano, Thomas Hardy, Benoit Beck, Eyas Abu-Raddad, Pasquale Palumbo, Juliana Bue-Valleskey, Niels Pørksen
2008 American Journal of Physiology. Endocrinology and Metabolism  
Few attempts have been made to model mathematically the progression of Type 2 diabetes. A realistic representation of the long-term physiologic adaptation to developing insulin resistance is necessary for effectively designing clinical trials and evaluating diabetes prevention or disease modification therapies. Writing a good model for diabetes progression is difficult, because the long time-span of the disease makes experimental verification of modeling hypotheses extremely awkward. In this
more » ... awkward. In this context, it is of primary importance that the assumptions underlying the model equations properly reflect established physiology and that the mathematical formulation of the model give rise only to physically plausible behavior of the solutions. In the present work, a model of the pancreatic islet compensation is formulated, its physiological assumptions are presented, some fundamental qualitative characteristics of its solutions are established, the numerical values assigned to its parameters are extensively discussed (also with reference to available cross-sectional epidemiologic data), and its performance over the span of a lifetime is simulated under various conditions including worsening insulin resistance and primary replication defects. The differences with respect to two previously proposed models of diabetes progression are highlighted, and the model is therefore proposed as a realistic, robust description of the evolution of the compensation of the glucose-insulin system in healthy and diabetic individuals. Model simulations can be run from the Authors' webpage.
doi:10.1152/ajpendo.90444.2008 pmid:18780774 fatcat:kotfbtkjwbdklhhioj3cu53qqi