Mathematical Modelling of Combined Intervention Strategies for the Management and Control of Plasma Glucose of a Diabetes Mellitus Patient: A System Dynamic Modelling Approach

With the rapid increase of diabetes mellitus cases in the world, management and control of the disease has become a complex and highly dynamic process. This challenge requires a multifaceted approach to manage and control the complications associated with the hyperglycaemia or hypoglycaemia conditions. This paper presents a mathematical model for determining the influence of combined intervention strategies in the management and control for the plasma glucose of the type II diabetes. System dynamics (SD) techniques were used in modelling the sub-compartments of biological systems of an Identifiable Patient (IP). The system dynamic model developed gave an illustration on how typical glucose-insulin dynamics occur at different intervention strategies involving varying amounts of carbohydrates taken, intensity of physical exercises, stress levels and the amount of exogenous insulin administered. The model was conceptualized within a semi-closed loop system representing the patient ecosystem by extending the Bergman Minimal Model. Stochastic differential equations (SDE) were used to capture the non-linear, continuous time varying interactions of the measurements associated with plasma glucose-insulin dynamics. The estimated results from the model showed combined intervention strategies of reduced amounts of carbohydrates intake, reduced stress levels and varying moderately high-to-low exercise intensity at a constant unit of exogenous insulin produced good plasma glucose levels control.