Mathematical model of blood glucose dynamics by emulating the pathophysiology of glucose metabolism in type 2 diabetes mellitus

Abstract This work addresses a physiological-based mathematical model of blood glucose dynamics in Type 2 Diabetes Mellitus (T2DM). The model emulates the pathophysiology of the T2DM metabolism including the gastric emptying effect and the enhancing effect on insulin due to the incretin hormones. Its mathematical structure considers a model of blood glucose dynamics of healthy humans developed with a physiological-based pharmacokinetic-pharmacodynamic approach. Then, the mathematical functions, representing the metabolic rates with a relevant contribution to hyperglycemia, are individually fitted to clinical data of T2DM patients. Methodologically, it allows emulating the pathophysiology of the T2DM condition. Numerically, the resulting model simulates successfully a programmed graduated intravenous glucose test and different-doses oral glucose tolerance tests. The comparison between simulations and clinical data shows a good agreement description of the blood glucose dynamics in T2DM and, it opens the likelihood of using this model to develop model-based controllers for blood glucose regulation in T2DM.