"Model-based Therapeutics in Type 1 Diabetes"

"Model-based Therapeutics in Type 1 Diabetes"

Abstract

The incidence of Type 1 diabetes is growing yearly. Worryingly, the aetiology of the disease is inconclusive. What is known is that the total number of affected individuals, as well as the severity and number of associated complications are growing for this chronic disease. With increasing complications due to severity, length of exposure and poor control, the disease is beginning to consume an increasingly major portion of healthcare costs to the extent that it poses major economic risks in several nations.

Since the 1970s, the artificial endocrine pancreas has been heralded as just this type of solution. However, no commercial product currently exists, and on-going limitations in sensors and pumps have resulted in, at best, modest clinical advantages over conventional methods of insulin administration or multiple daily injections. With high upfront costs, high costs of consumables, significant complexity, and the extensive infrastructure and support required, these systems and devices are only useful for 2-15% of individuals with Type 1 diabetes. Clearly, there is an urgent need to address the large majority of the Type 1 diabetes population using conventional glucose measurement and insulin administration. However, these individuals, current conventional or intensive therapies are also failing to deliver recommended levels of glycaemic control.

This presentation presents a model-based approach using virtual patients to develop new therapies and approaches. These approaches are well validated in other clinical environments. The models are derived, and physiologically based. The resulting models are used to develop and analyse current and new methods for treatment, as well as new insulin types used in treatment. The results are validated against current clinical results and thinking. The overall outcome is an in-depth analysis of existing treatment, a definition and clear analysis of how much effort (measurement and injection) is required to achieve ADA specified control levels, and new approaches to best achieve that goal.