Mixed Meal Model in Type 1 Diabetes

―Minimal Compartments of Triglycerides and Non-esterified Fatty Acids

Abstract

In keeping with the recent recognition of the additive impact of dietary fat on postprandial blood glucose (BG) levels in type 1 diabetes mellitus (T1DM), we include a number of physiologically-relevant improvements to a previous conceptual minimal mixed meal model by considering independent signals for gut transit of carbohydrates and dietary fat, and explicit representation of fatty acid spillover in the compartmental representation of non-esterified fatty acids (NEFA) to represent lipid-derived insulin resistance as the complementary increase in triglycerides (TG) and NEFA levels. Simulation results of postprandial plasma lipids and BG excursion compared with clinical data in the literature demonstrate the validity and potential of the minimal mixed meal model proposed.