Modeling Carbohydrate Counting Error in Type 1 Diabetes Management.

Background: The error in estimating meal carbohydrates (CHO) amount is a critical mistake committed by type 1 diabetes (T1D) subjects. The aim of this study is both to investigate which factors, related to meals and subjects, affect the CHO counting error most and to develop a mathematical model of...

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Publicado en:Diabetes Technology & Therapeutics Vol. 22; no. 10; pp. 749 - 760
Autores principales: Roversi, Chiara, Vettoretti, Martina, Del Favero, Simone, Facchinetti, Andrea, Sparacino, Giovanni
Formato: equations & formulas research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Oct2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2020
      vid: 22
      iid: 10
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
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        10.1089/dia.2019.0502
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        atl: Modeling Carbohydrate Counting Error in Type 1 Diabetes Management.
      aug:
        au:
          Roversi, Chiara
          Vettoretti, Martina
          Del Favero, Simone
          Facchinetti, Andrea
          Sparacino, Giovanni
        affil: Department of Information Engineering, University of Padova, Padova, Italy.
      sug:
        subj:
          Diabetes Mellitus, Type 1 Diet Therapy
          Dietary Carbohydrates Analysis
          Models, Theoretical
          Diabetes Mellitus, Type 1 Drug Therapy
          Human
          Adult
          Blood Glucose
          Insulin
          Meals
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Adult: 19-44 years
      ab: Background: The error in estimating meal carbohydrates (CHO) amount is a critical mistake committed by type 1 diabetes (T1D) subjects. The aim of this study is both to investigate which factors, related to meals and subjects, affect the CHO counting error most and to develop a mathematical model of CHO counting error embeddable in T1D patient decision simulators to conduct in silico clinical trials. Methods: A published dataset of 50 T1D adults is used, which includes a patient's CHO count of 692 meals, dietitian's estimates of meal composition (used as reference), and several potential explanatory factors. The CHO counting error is modeled by multiple linear regression, with stepwise variable selection starting from 10 candidate predictors, that is, education level, insulin treatment duration, age, body weight, meal type, CHO, lipid, energy, protein, and fiber content. Inclusion of quadratic and interaction terms is also evaluated. Results: Larger errors correspond to larger meals, and most of the large meals are underestimated. The linear model selects CHO (P < 0.00001), meal type (P < 0.00001), and body weight (P = 0.047), whereas its extended version embeds a quadratic term of CHO (P < 0.00001) and interaction terms of meal type with CHO (P = 0.0001) and fiber amount (P = 0.001). The extended model explains 34.9% of the CHO counting error variance. Comparison with the CHO counting error description previously used in the T1D patient decision simulator shows that the proposed models return more credible realizations. Conclusions: The most important predictors of CHO counting errors are CHO and meal type. The mathematical models proposed improve the description of patients' behavior in the T1D patient decision simulator.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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