Risk of type 1 diabetes at 3 years is high for initially multiple and single Ab+ IT and multiple Ab+ NT. Genetic predisposition, age, and male sex are significant risk factors for development of Ab+ in twins.
The glucose-insulin system is a challenging process to model due to the feedback mechanisms present, hence the implementation of a model-based approach to the system is an on-going and challenging research area. A new approach is proposed here which provides an effective way of characterising glycaemic regulation. The resulting model is built on the premise that there are three phases of insulin secretion, similar to those seen in a proportional-integral-derivative (PID) type controller used in engineering control problems. The model relates these three phases to a biological understanding of the system, as well as the logical premise that the homeostatic mechanisms will maintain very tight control of the system. It includes states for insulin, glucose, insulin action and a state to simulate an integral function of glucose.Structural identifiability analysis was performed on the model to determine whether a unique set of parameter values could be identidied from the available observations, which should permit meaningful conclusions to be drawn from parameter estimation. Although two parameters -glucose production rate and the proportional control coefficient -were found to be unidentifiable, the former is not a concern as this is known to be impossible to measure without a tracer ex- * Principle corresponding author * * Corresponding author
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