QUERY Physiological Diabetes Models

[j-d <jaideep@optimlator.com&g]

Posted by j-d <jaideep@optimlator.com>

I am wondering if there is/are publicly available paper/s and/or
system dynamics model/s simulating the role of various hormones
(insulin, glucagon, etc.) in diabetes, for understanding and
management of the disease.

I vaguely remember there being something in SDR a few years ago. Most
of the studies seem to be in the area of public policy as it relates
to spread of diabetes and/or other diseases. My interest is in looking
at models simulating the internal mechanisms (inside the body). From
my little study of the endocrine system, it has all the patterns of a
nonlinear system with delays, unintended effects, limits,
unpredictable behavior and so on (in other words, a complex system).
The same patterns are obvious when one looks at various diets in the
prevention and/or management of obesity. Just like climate change or
Limits to Growth models, management of these complex systems is tricky
- for example, policy change in one area (various diet regimens, or
various hormone administrations through diet modifications or
injections) has possible good or bad effects elsewhere (this is
familiar to members on this list, especially for those who have played
with Beer Game and LTG models).

I would be surprised if there are no such models - human body, as it
is managed within some strict ranges (temperature, hormones, glucose,
and so on) can be modeled as a structured system. There is a huge
amount of medical data available. This will require an interface
between endocrinologists and system dynamics modelers - if it has not
already been done. Perfect project for an interface between SD and
medical sciences - part of a Masters or a Ph. D. project maybe!!

Would it be possible for someone to provide references or, better
still, the model/s itself?

Much thanks

Jaideep

Jaideep Mukherjee, Ph. D.
Posted by j-d <jaideep@optimlator.com>
posting date Mon, 30 Jun 2008 09:43:46 -0500
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[j-d <jaideep@optimlator.com&g]

Posted by j-d <jaideep@optimlator.com>

Thanks Jack for the references, especially the book. I don't work in
the medical field, and have been out of SD for a while too (though my
Ph. D. work was a detailed study and extension of SD LTG models) - so
I am not up with the literature. I was intrigued by the similarities
in patterns of pathology in internal (obesity, cancer, diabetes, etc.)
and external (climate change, overpopulation, and so on) human
""diseases"". Hence the request. Google search reveals some medical
models, though I thought SD can be a valuable tool to study this
dynamics, and hopefully to help find some solutions to the
pathologies. A simple (not simplistic) SD model can convey the
dynamics much better than tens of pages of complicated medical text.

Thanks Ewaldt for the references. Most of them unfortunately relate to
public policy regarding management and control of diabetes or cancer.
I am looking for something different.

Thanks to Jack Homer's help, I was able to check the SD bibliography
at http://www.systemdynamics.org/biblio/sdbib2.html
where I found the following 11 references related to my interest. I am
also buying the book (by Arthur Guyton) that Jack mentioned. Wouldn't
it be great to have easy access to these articles and models (online)
- the one thing I truly miss about academia (maybe SD Society can open
its SDR archives online for a reasonable fee for non-academicians;
British Medical Journal, New England Journal of Medicine, etc. and
many others do it!!).

[ Just a note that the System Dynamics Review is available online
to all members of the Society ]

If there are any medical professionals on this list, please guide me
to any suitable references, such as below. It is possible someone has
done similar studies, but not using system dynamics approach or
software, because the problems seem amenable to control
theory/engineering type approaches.


Best regards

Jaideep
Posted by j-d <jaideep@optimlator.com>
posting date Tue, 1 Jul 2008 09:47:46 -0500
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[Ewaldt Jörn <ewaldt@conmoto.d]

Posted by Ewaldt Jörn <ewaldt@conmoto.de>

Dear Jaideep,

I found the following 8 references that may help. The total list of SD
references
for health care in my database contains about 300 items, but I am no medical
expert. So, I only can follow the title information and some key words to
vaporize the list. In case you need the whole list, please send me an email.

Al-Qatawneh, Lina K.; Hafeez, Khalid; Tahboub, Zain (2003): Health Care Supply
Chain Dynamics: Systems Design of an American Health Care Provider. In:
Eberlein,
Robert L.; et al. (eds.): Proceedings of the 21th International Conference of
the
System Dynamics Society. New York .

Dangerfield, Brian C. (1999): System dynamics applications to European health
care issues. In: Journal of the Operational Research Society, vol. 50, no. 4,
pp.
345-353.

Dangerfield, Brian C.; Roberts, Carole (1999): Foreword to the Special Issue on
Health and Health Care Dynamics. In: System Dynamics Review, vol. 15, no. 3, pp.
197-199.

Eyre, H.; et al. (2004): Preventing cancer, cardiovascular disease, and
diabetes:
a common agenda for th American Cancer Society, the American Diabetes
Association, and the American Heart Association. In: Diabetes Care, vol. 27, pp.
1812-1824.

Georgantzas, Nicholas C.; Trilling, Kelley; Chou, Yun (1998): Rezukin: Effective
and Efficient Drug for Diabetes. In: System Dynamics Society (ed.): Proceedings
of the Sixteenth International Conference of the System Dynamics Society Québec
'98. Québec .

Homer, Jack B.; et al. (2004): The CDC's Diabetes Systems Modeling Project:
Developing a New Tool for Chronic Disease Prevention and Control. In: Kennedy,
Michael S.; et al. (ed.): Proceedings of the 22th International Conference of
the
System Dynamics Society. Oxford .

Honeycutt, A. A.; et al. (2003): A dynamic Markov model for forecasting diabetes
prevalence in the United States through 2050. In: Health Care Management
Science,
vol. 6, pp. 155-164.

Tretter, Felix (2005): Systemtheorie im klinischen Kontext - Grundlagen -
Anwendungen. Lengerich.

Best regards

Jörn Ewaldt
- project manager -

CON MOTO Consulting Group GmbH
Posted by Ewaldt Jörn <ewaldt@conmoto.de>
posting date Tue, 1 Jul 2008 16:49:07 +0200
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[Gonenc Yucel <g.yucel@tudelft]

Posted by Gonenc Yucel <g.yucel@tudelft.nl>

Dear Jaideep,
I am personally not aware of modeling work on endocrinological systems regarding
diabetes.
However, there were a couple of modeling studies supervised by Yaman Barlas
about
different health issues.

The first one was about body water balance by Ozge Karanfil (presented in 2006
conference in Nijmegen), and the second one was about hyper tension progression
by Firat Incioglu (presented in 2007 conference in Boston). As far as I
remember,
the first one got the Meadows award in 2006, while the second was a runner-up in
2007.
I am not aware of any other work, but I am sure some people in Yaman's research
group are continuing to work in this line of subjects (i.e. modelling
physiological systems in the human body).

Probably, Jack Homer already mentioned these two.

best regards,
gonenc

-------------------------------------------------------------
Gönenç Yücel
PhD Researcher, Policy Analysis Section
Faculty of Technology, Policy & Management
TU Delft
Posted by Gonenc Yucel <g.yucel@tudelft.nl>
posting date Wed, 2 Jul 2008 17:44:10 +0200
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[""Eng. Fadhl Al_Akwaa"" <fadl]

Posted by ""Eng. Fadhl Al_Akwaa"" <fadlmaster1@yahoo.com>

Dear Dr Jaideep
the linked below is my physiological model of diabetes, it was my Msc thesis
with Dr Khaled Wahba ,2006.
I studied the oscillation of Glucose & insulin in blood.
we build a feedback loop system which have a lot of application.
I think SD strength is shown with this model through its simplicity, and strong
prediction.
Dr Khalid Group at Cairo University try to study the human body behavior
(glucose&insulin , hemodialyesis, etc) using SD.
do not be hesitate if you have any question.
with best regards

http://rapidshare.com/files/93575355/GR ... Thesis.pdf
Fadhl M. Al-Akwaa
Biomedical Engineering, PhD Student
Bioinformatics Group
Posted by ""Eng. Fadhl Al_Akwaa"" <fadlmaster1@yahoo.com>
posting date Thu, 3 Jul 2008 05:51:49 -0700 (PDT)
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[Bill Harris <bill_harris@faci]

Posted by Bill Harris <bill_harris@facilitatedsystems.com>

Jaideep,

I have no pointers to diabetes models, but you might be interested in
PBPK (physiologically-based, pharmaco-kinetic) modeling. Their models
look for all the world like SD models to me; indeed, MCSim, the open
source simulator I've written and spoken about and that I use, is from
the PBPK community.

Bill
- --
Bill Harris
Posted by Bill Harris <bill_harris@facilitatedsystems.com>
posting date Thu, 03 Jul 2008 07:28:53 -0700
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[<klausv@stud.ntnu.no>]

Posted by <klausv@stud.ntnu.no>

Here is a good reference :

Richard O. Foster, 1970: The Dynamics of blood sugar regulation, MSc thesis, MIT
Dept of Electrical Engineering .

It's aviailable on the MIT System DYnamics Group Literature Collection,
and in the MIT Electronic Libraries

Klaus

Klaus Vogstad, PhD
Special Adviser Agder Energi
Adj. Associate Prof. NTNU Dept of Industial Economics
Posted by klausv@stud.ntnu.no
posting date Sat, 5 Jul 2008 10:55:35 +0200
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[<ybarlas@boun.edu.tr>]

Posted by <ybarlas@boun.edu.tr>

Dear Jaideep,

This is an indirect reply to your question. (Also to Kirandeep's query on
cardiac defibrillator adoption modeling perhaps).

Gonenc Yucel already referred to some work that we do on physiological modeling
here at Bogazici U. Indeed, in the past few years we declared 'medical
modeling' as a priority area. We believe that there is perhaps greatest
potential here -potential to make a long term and deep impact on other fields
and public in general. So in the past few years we have produced several theses
and papers on different med modeling. three complete citations are below. Each
of these have corresponding theses that one can obtain by contacting us or our
library.

(As Gonenc said, Karanfil's paper won DM award and Incioglu's received a
runner-up prize. Ali Osman decided not to enter the DM competition this year -
I guess to give other places a chance to win:))

More seriously, we hope to have a series of papers published on the subject
soon. Karanfil's is accepted for publication in Operations Research.
And as others have replied, there are other excellent modeling work worldwide on
different medical problems.

I hope this may be of some use and please let us know if you need mor info.
best,

Yaman Barlas
---------------------------------------------------------------------------
Yaman Barlas, Ph.D.
Professor & Chair, Industrial Engineering Dept.
Bogazici University,
34342 Bebek, Istanbul, TURKEY
Fax. +90-212-265 1800. Tel. +90-212-359 7073
http://www.ie.boun.edu.tr/~barlas
SESDYN Group: http://www.ie.boun.edu.tr/labs/sesdyn/
-----------------------------------------------------------------------------

Karanfil, Ö., 2006, A Dynamic Simulator for the Management of Disorders of the
Body water Metabolism, Proceedings of the 24th International System Dynamics
Conference, Nijmegen.

Incioglu, Firat., 2007 A Dynamic Simulation Model for Long-Term Hypertension
Progression, Proceedings of the 25th International System Dynamics Conference,
Boston.

Konuray, Ali Osman, 2008. Development of tolerance and dependence to
barbiturates: A Systems modeling approach, Proceedings of the 26th
International System Dynamics Conference, Athens (to appear)
Posted by ybarlas@boun.edu.tr
posting date Mon, 7 Jul 2008 19:33:18 +0300
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[""gmcdonne@bigpond.net.au"" <]

Posted by ""gmcdonne@bigpond.net.au"" <gmcdonne@bigpond.net.au>

See Ozge Karanfil's page on the HPSIGwiki for a large number of Physiological
model references
http://www.hpsig.com/index.php/Systems_ ... Physiology

Posted by ""gmcdonne@bigpond.net.au"" <gmcdonne@bigpond.net.au>
posting date Wed, 9 Jul 2008 16:55:41 +1000
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[""eric wolstenholme"" <eric.w]

Posted by ""eric wolstenholme"" <eric.wolstenholme@symmetricsd.co.uk>

On the subject of Body Physiology models, has anyone knowledge of
neurological/brain models?

Best Wishes
Eric
-------------------------------------
Professor Eric Wolstenholme
Professor of Business Learning, London South Bank University
Director, Symmetric SD Ltd
Posted by ""eric wolstenholme"" <eric.wolstenholme@symmetricsd.co.uk>
posting date Wed, 9 Jul 2008 14:12:00 +0100
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[wakeland@pdx.edu Regarding Er]

Posted by wakeland@pdx.edu

Regarding Eric's question about ""brain""-related physiological models:

> Posted by ""eric wolstenholme"" <eric.wolstenholme@symmetricsd.co.uk>
>
> On the subject of Body Physiology models, has anyone knowledge of
> neurological/brain models?

I have done some modeling of intracranial blood flow and pressure, initially
in Stella and later ported to Matlab. Links are available here:

http://www.pdx.edu/sysc/research_dynami ... ation.html

Wayne Wakeland, Ph.D.
Associate Professor
Systems Science Graduate Program
Portland State University
Posted by wakeland@pdx.edu
posting date Thu, 10 Jul 2008 09:40:23 -0700
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