Computer Simulation of Plasma Insulin and Glucose Dynamics After Subcutaneous Insulin Injection

  1. David Rodbard, MD
  1. Laboratory of Theoretical and Physical Biology, National Institutes of Child Health and Human Development, National Institutes of Health Bethesda, Maryland
  1. Address correspondence and reprint request to David Rodbard, MD, Laboratory of Theoretical and Physical Biology, National Insitutes of Child Health and Human Development, National Institutes of Health, 9000 Rockville Pike, Building 10, Room 6C101, Bethesda, MD 20892.

Abstract

We developed a computer program for the simulation of plasma insulin and glucose dynamics after subcutaneous injection of insulin. The program incorporates a pharmacokinetic model to calculate the time courses of plasma insulin for various combinations of popular preparations (regular, NPH, lente, and ultralente). With the use of a pharmacodynamic model describing the dependence of glucose dynamics on plasma insulin and glucose levels, the program can predict the expected time course of plasma glucose in response to a change in carbohydrate intake, insulin dose, timing, or regimen. A set of typical parameters has been obtained by analysis of data from the literature. The results of several computer simulations are presented showing the effect on a 24-h insulin and glucose profile of systematically changing insulin regimen, dose, timing of meals, or timing of preprandial insulin administration. The program can be used to explore on a theoretical basis the impact of various factors associated with glycemic control in insulin-dependent diabetes mellitus. As an educational tool, the program provides a realistic environment for demonstration of the combined or isolated effects of insulin and diet on glycemia

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