Background

A good treatment for type 1 diabetes mellitus (T1DM) requires accurate measurements of blood glucose levels. Continuous glucose monitors (CGM) measure the glucose concentration in the interstitial fluid of the abdominal subcutaneous adipose tissue. However, glucose measured in the abdominal interstitial fluid does not represent blood glucose concentrations accurately due to the complex blood transport through the body and glucose diffusion in interstitial fluid.

Methods

To gain insight into this problem, a phenomenological-based semiphysical model (PBSM) of glucose transport by volumetric flow and diffusion from the bloodstream to interstitial fluid was constructed. A published 10-step modeling procedure was used to obtain a model for glucose transport time through the blood vessels and from the blood capillaries to the interstitial fluid, glucose diffusion within the interstitial fluid, and glucose diffusion through the semipermeable coating of the sensor needle. For this model, a healthy person is considered at rest with average parameters.

Results

The simulations performed using the PBSM allow obtaining the glucose transport time from the liver to the sensor needle. In this way, it is possible to reconstruct an accurate dynamic measurement of blood glucose from the measurements in the interstitial fluid of the abdominal subcutaneous adipose tissue.

Conclusions

PBSMs with parameters interpretability illustrate the connection of glucose concentrations in the interstitial fluid with that currently in the blood. Implementing this model in a CGM will result in more reliable measurements of blood glucose levels for T1DM treatment.

中文翻译：

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葡萄糖从肝脏到腹部皮下脂肪组织的基于现象学的模型

背景

1 型糖尿病 (T1DM) 的良好治疗需要准确测量血糖水平。连续血糖监测仪 (CGM) 测量腹部皮下脂肪组织间质液中的葡萄糖浓度。然而，由于通过身体的复杂血液运输和间质液中的葡萄糖扩散，在腹部间质液中测量的葡萄糖不能准确地代表血糖浓度。

方法

为了深入了解这个问题，构建了一个基于现象学的半物理模型（PBSM），通过体积流动和从血流扩散到间质液的葡萄糖运输。已发布的 10 步建模程序用于获得葡萄糖通过血管和从毛细血管到间质液、间质液内的葡萄糖扩散以及葡萄糖通过传感器针的半透涂层扩散的模型。对于这个模型，一个健康的人被认为是具有平均参数的休息。

结果

使用 PBSM 执行的模拟允许获得从肝脏到传感器针的葡萄糖运输时间。以这种方式，可以根据腹部皮下脂肪组织的间质液中的测量值重建准确的动态血糖测量值。

结论

具有参数可解释性的 PBSM 说明了组织液中的葡萄糖浓度与当前血液中的葡萄糖浓度之间的联系。在 CGM 中实施该模型将为 T1DM 治疗提供更可靠的血糖水平测量值。