6
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Diabetes Learning Lab in Stella 10
Glucose concentration levels in blood
Designing the future from within
Published for:
The 31st International Conference of the System Dynamics Society,
Cambridge, Massachusetts USA
July 21 - July 25, 2013
AUTHORS
Pedro Dagoberto Almaguer Prado pedrodago@ gmail.com Author
Beatriz Eugenia Navarro Vazquez bety.5505@ gmail.com Collaborator
Ruth Raquel Almaguer Navarro ruth_ran@ hotmail.com Design
Ramiro Luis Almaguer Navarro rmalmaguer@ gmail.com Modeling
Pedro Dagoberto Almaguer Navarro pan.dago82@ gmail.com Collaborator
leo)
Abstract
In this activity, the body reaction in the intake of food will be simulated: Food amount; type of
food; when the intake of food took place; how fast the digestion occurs; reaction time of the
pancreas; theconnection between the blood glucose concentration and_ the insulin
production.
The content will alsocover the subject between the coordinated and harmonious
functioning of the pancreas (which secretes insulin), the liver, and the body's cells (insulin
receivers). The Homeostasis: Process that regulates the blood concentration. Together we'll
discover the cause-effects cycles that characterize the problem andhow theybecome an
important part of the solution.
This article will span the effect of pancreas’ insulin production in diabetes type |, as well as the
cells’ glucose uptake and their rejection to insulin, all this with the intention of visualizing
how it breaks into the cause-effect cycles that regulates the blood glucose concentration in
the body, triggering the imbalance in health.
Keyword: Learning Labs, Social Sciences, Biology, system dynamics, diabetes, glucose, insulin, Cause-
effect cycle, public health, modeling and simulation.
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
List of Contents
Abstract (e)
Introduction: 2
Background: Glucose and Insulin and the Role of Pancreas. 3
The Diabete: 5
Model. 7
CGS Model Equations. 16
Graphic results of the model to a healthy person. 17
Case 2: Eating 3 candy bars. 20
Case 3: Eating complex carbohydrates as pasta and then a delicious dessert 21
Diabetes type |. 23
Diabetes type II. 24
Facts that a diabetic should take into account. 25
Diabetes learning lab - in Stella 10 (English) 26
Conclusions 30
Bibliography 31
Details of the author and collaborators: 32
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Introduction:
When | was studying the Chemical Engineering and Systems degree in the Instituto
Tecnoldgico de Estudios Superiores de Monterrey (I.T.£.S.M.) in 1979, | had the opportunity to
study a really hard subject named “Sistemas de Control” (Control systems) in the mechanics
field which introduced us to the establishment of the regulatory mechanisms of water levels in
a tank, or temperature in a room, or open and close gates on a dam and some other issues like
that. In those years it was necessary a deep understanding of higher mathematics and lots of
theory that we could only imagine in our minds since there were not computers to display a
basic representation of the behavior over the time of such systems and thus be able to
visualize in a clearer way the impact of our decisions when altering these control mechanisms.
| remember with great clarity an occasion that my Professor Enrique Gonzalez (who was a
great teacher in the subject that could have been the hardest class | took in my career). We
were assigned a task to go to the library (though there was not internet) to find examples
of self-regulatory systems within our body. | was rather surprised to see that we are full of
those systems, everywhere, if we examine what happens to our circulatory system with many
control cycles that regulates the blood flow valves automatically. In addition we must mention
the mechanisms that regulate temperature, breathing, heart rate, etc. The truth is that | was
embodied with this discovery. Human body is truly a perfect machine. It’s a wonder of God in
the creation.
Who could imagined that 30 years later, all this issues would connect to the content of this
article developed to understand in a better way the Diabetes, its negative feedback cycles
regulate self glucose level concentration in blood to a healthy limit, which connects every meal
to the release of glucose in the digestive process, with the pancreas and insulin secretion, liver,
kidneys, bloodstream and the energy required by cells.
Steps to develop learning laboratories.
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SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Background: Glucose and Insulin and the Role of Pancreas.
We get most of our glucose in the digestion process from sugar, starch and
carbohydrates. Foods such as rice, pasta, cereals, potatoes, fruits, some vegetables and,
processed candies already classified as carbohydrates. Our digestive system, in addition to the
bile and enzymes, work breaking down the starch and sugar founded in food turning it into
glucose. This functional form of energy is then absorbed through the small intestine into the
bloodstream. There, combined with glucose, a chemical known as insulin is secreted by the
pancreas. Together, they’re absorbed by cells in the muscles and brain, allowing glucose to
bring the needed energy for developing activities such as lifting a book or remembering a
phone number.
Due to the fact that it is a vital form of energy, and it interacts with both the digestive and
endocrine systems, to maintain glucose within a normal range is critical to health. Our body is
adapted to maintain this ideal glucose level by storing excess of sugar as glycogen in the liver,
so it can be reabsorbed when sugar levels drop.
Glucose.
Glucose, a simple sugar, is the main source of energy for most organisms. The human body
makes glucose from food and transports it to cells through the bloodstream. Glucose is
measured in milligrams per blood deciliter {mg / dl}. The average of a healthy human being is
about 60 {dl} of blood (6 liters) and, between every meal, blood glucose levels about 100 {mg /
dl} or 6000 mg circulating in the blood. (The range average of a person who is fasting is {70 to
120 mg / dl}.)
The amount of glucose in blood varies with food intake and also with fat breakdown by the
liver to produce glucose. The glucose release is measured in {mg / min}.
Pancreas.
The pancreas controls the level of blood glucose by secreting the hormone insulin in response
to an increased glucose level. The pancreas secretes insulin in beta cell groups called islets of
Langerhans, after the German scientist with this name was the first describing them.
As insulin circulates in the blood, the body’s cells take glucose from the blood. Therefore
glucose level decreases, causing the pancreas to secrete less insulin. This interrelationship
between glucose and insulin is an example of many other feedback cycles, and it works
similarly to the way that a home thermostat controls the temperature of the room.
Insulin.
Insulin helps cells to take glucose. It makes the cell membrane more permeable to sugar. The
rate of normal insulin secretion is about 500 {mg / min}, this is the amount needed to maintain
the balance between insulin and glucose. This balance is essential for homeostasis, which is
the normal and healthy condition in the internal environment of the human body. The level of
insulin is measured in units (1 unit = 1 mg) and the rate of insulin secretion in {mg / min}.
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Use of glucose.
Cells use glucose to provide their energy needs. The non essential glucose to produce energy is
then converted into glycogen in the liver and the muscles. These cells convert the glycogen
into glucose when the body needs it. The glucose excess is stored as fat in the body. The
glucose usage rate is measured in {mg / min}.
Insulin decomposition.
Insulin is degraded shortly after the secretion. Every minute 1 / 18 of insulin are broken down
in the blood (in other words, insulin has a useful lifetime of 18 minutes). As the insulin levels
increase, the more insulin is degraded in the lower levels. That is, the degradation rate is faster
in elevated insulin levels.
Homeostasis
It literally means "in the same state" and refers to the process of maintaining the internal
environment of the body in a steady state or equilibrium when the external environment is
changed. Much of the hormonal system and the autonomic nervous system are dedicated to
the homeostasis, and its action is coordinated by the hypothalamus. There are many examples
of living organisms that are operated by the Homeostasis, among it bears mentioning:
1. Breathing.
2. Heart rate.
3. The body temperature control.
4. The blood glucose control.
5. Water control in the blood.
All homeostatic | mechanisms use a negative feedback cycletomaintainan unchanging
value (called theset point). Negative feedback means that whena change occurs inthe
system, it automatically starts a corrective mechanism, reversing the occurred change and
bringing the system back to the set point again (that is, the 'normal' state).
Thus, ina system controlled by a negative feedback cycle, the ideal level is never perfectly
maintained, but it varies constantly on the set point. The oscillation size is minimized by an
efficient homeostasis process. However, some variations would be allowed. Otherwise, both
corrective mechanisms would try to operate at once! This fact is particularly true in the
homeostatic mechanisms controlled by hormones (and most of them are) in which there
is a significant time lag before the corrective mechanism can be activated. The reason this
happens is because to initiate the synthesis of proteins, the diffusion of hormones into the
bloodstream and circulation throughout the body and produce effect, takes time.
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
The Diabetes
Maintaining an equilibrated blood glucose level is critical for the human body. If the amount of
glucose in the blood is too high or too low, serious physical problems may occur.
In people with diabetes, the bodycannotproperlycontrol its blood glucose
level. Diabetics need to adjust their diet and exercise style, inclusive; in some cases they might
use medication.
There are other natural remedies in medicine that are being very effective in the treatment of
diabetes. One of them is the tea leaves of Neem tree from India, which is very cheap and
extremely effective.
Homeostasis: cause-effect cycles 1
It stimulates the
+ glucose uptake
by cells
Tissue cells
It estimulates +
the glycogen
formulation A (a B2
Pancreas Glucose Sepa Blood glucose
. drops to
normal levels
+
Stimulus: Risin
blood iucose” (ay
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Lt Stimulus: Blood
glucose level falls
Blood glucose
Stimulates
glycogen
breakdown
-_
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rises to the R1
normal rank
Pancreas
A .
a
Figure 1: Diabetes cause-effect cycles of Homeostasis.
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Homeostasis: cause-effect cycle 2.
Body cells take a
major amount of
glucose
Insulin
Pancreatic beta cells +
stimulate the release
of insulin in blood f* Cat
The blood glucose level
(#2
decreases to an
a: adjustment point:
stimulus to decrease the
glucose level
The liver takes de glucose
and stores it as glycogen
ESTIMULUS:
ESTIMULUS: x aes
The i increasing o ofblen a * The elimination of blood
| (fo
glucose excess,
« Low blood glucose level
(for instance: after fasting
high-carbohydrate
meal) Low’ ‘one meal)
(ary
The blood glucose
level increases to the
adjustment point. The
stimulus for glucagon
Ieee decrees Pancreatic alpha cells
stimulus to release the
glucagon in blood
+
The liver breaks down
glycogen and releases Glucagon
glucose into the ase =
glucose level
instance: after a
Figure 2: Diabetes cause-effect cycles of Homeostasis ilustrated.
Diabetes type I.
In diabetes type |, beta cells secrete insulin in a little amount or not. Type lis often known
as juvenile diabetes because it is more common in young people.
Diabetes type II.
In diabetes type II, the pancreas secretes insulin at healthy rates, but the body cells do not take
the glucose because they do not respond well when insulin works to give them the glucose.
Diabetes type II is often called Diabetes of the Adult or non-insulin-dependent diabetes
mellitus.
The Glucose Tolerance Test.
A glucose tolerance test is often used to diagnose diabetes. The test measures the body's
ability to use glucose. Before, a fasting for 8 to 12 hours is needed, and then a
solution containing 75 grams of glucose is taken. During the next 3 hours,
four blood samples are taken at equal time intervals. For a healthy person, the blood glucose
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
concentration is lower than 195 {mg / dl} after 1 hour, less than 160 {mg / dl} after 1.5
hours and, less than 140 {mg / dl} after 2 hours.
Conditions after a glucose tolerance test of glucose are shown in the table below:
Condition Glucose Blood level {dl} Blood Glucose Total
concentration deciliters Amount of {mg}
{mg/dl}
Normal Blood Glucose 80-110 60 4,800 — 6,600
Concentration
Hypoglycemia <40 60 < 2,400
Renal Threshold 160 - 180 60 9,600 — 10,800
Hyperglycemia >210 60 > 12,600
Glucose Healty Level of 100 60 6,000
the Model.
Insuline Healty Level of 150 60 9,000
the Model.
Renal Threshold for the 160 60 9,600
Model.
Table 1: Glucose condition’s, glucose reference bands in a healthy person with a blood level of 6 litters.
Model.
This model simulates the body's reaction when the intake of food has place: food amount,
type of food, when does the intake of food took place, how fast the digestion occurs, and
reaction time of the pancreas. The insulin secretion rate is defined as a graphical-function,
based in the blood glucose excess.
Ifthe glucose levelis normal (homeostasis), there isn’t aglucose excess. The surplus is
zero and the insulin secretion rate is about 500 {mg / min}, maintaining the equilibrated state
also called homeostasis.
If the surplus is positive, then the insulin secretion rate increases to a level that beta cells can
not keep. The rate begins to decline despite a high level of glucose.
If the surplus is negative (a fewer glucose level than homeostatic), the insulin secretion rate
decreases as the body conserves glucose by decreasing the speed at which cells take it. Beta
cells alsohave alower limitin the insulin production. In the model this limit is set at
zero, although the beta cells are always making some insulin.
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
The Basic Structure.
Glucosa utilizada
por las células
* nh.
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Liberada la Sangre
Insulina en Descompésicién
la Sangre de Insulina
Secrecién
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Tiempo de
Glucose release.
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om
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SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Estimative rough of blood volume.
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Sube y Baja Aura
Volumen
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Pasta
st CO comida Glucose utiizada pri
poate Nenes por las células
ae
& Bit PES The blood volume.
Glucosa Glucosa on i
Liberata Is Sangre The blood volume in individuals can be
calculated using the Nadler model just
defining the weight in kilos and height in
meters.
In this way we can calculate the blood
glucose concentration in {mg / di}. and
blood insulin concentration in similar
units.
Insutina en Descompésicién
la Sangre de Insulina
Secrecién
de Insuline
Tiempo de
vida citi
eg volot
Formulas used to calculate the blood volume.
Based on the gender, weight {kilos} and height {meters} of an individual given, it is possible to
calculate the blood volume {liters} of his body, using the Nadler model.
If he is a man:
Blood volume = 0.3669* (height)’ + 0.03219* (weight) + 0.6041 {liters}
If she is a woman, then is used:
Blood volume = 0.3561* (height)* + 0.03308* (weight ) + 0.1833 {liters}
This model givesus a blood volume accurate result of an individual in {liters}, due to
our model needs the volume in {dl}, thenthe previous result needs be multiplied by
10, turning out as follows:
Vol DL = Blood Volume * 10 {dl}
Litters can also be expressed as {It}, the deciliters are also represented as {dl}, kilos {kg} and
meters are abbreviated as {mt}. When we talk about blood volume glucose (CGS) or insulin
volume glucose (CIS), this is expressed in units of {milligrams/deciliters} or abbreviated as
{mg / dl}.
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Parameters and conditions of blood glucose.
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Model parameters.
Based volume Nand Q
volume "CGS Meta" {mg / di} itis possible to calculate different parameters and
conditions or glucose strips amang it's worth to mention:
1. The heathy insutn blood level in {mg}
2.The healthy glucose and insulin concentration in {mg/d}.
3. The strip where Hypoglycemia occurs in {ma} and {ma / dl}
4, Estimative time when renal troubles might arise.
5. The glucose condition for Hyperglycemia in {mg} and {mg / dl}
Tiempo de
vida iil
Vol DL
\
On!
Hiparglucemia MG
Factor Hiperglucasa Factor Umbral Ranal Factor Hipoglucosa
vs CGS vs CGS vs CGS
Hipoglucemia
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Characteristic of the person and the key factors in the model.
For the basic calculations of the model, select a healthy man whose weight and height turns
out in a blood volume of 6 liters {It} or 60 deciliters {dl}, it is assumed that the healthy
concentration of glucose (CGSMeta) about
100 {mg / dl} and its
equivalent insulin
concentration (CIS Meta) of 150 {mg / dl}, based on these data, we can do the calculations on
lines (1) and (2) of the following table.
Number | Condition Concentration | Total Amount Factor
{mg/dl} {mg} {Unite
number}
1 Aim of glucose blood 100 6,000
volume
2 Aim of insulin blood volume 150 9,000 1.50
3 Hypoglycemia 40 2,400 0.40
4 Renal Threshold 160 9,600 1.60
5 Hyperglycemia 210 12,600 2.10
Table 2: The factor is calculated as the ratio between each condition or glucose strips.
10
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
The Datafor strips or conditions of glycemia in hypoglycemia, renal threshold and
hyperglycemia are widely reported in scientific papers relatedto glucose and there are
not exact figures. Always mentioned within a small range, for instance the normal renal
thresholdis always reported between 160 to 180 {mg/dl}, we have to select 160
{mg / dl} to be used in our calculations. The factor column for lines (3), (4) and (5) is calculated
as the ratio of the band about healthy glucose amount.
Another important consideration is that the total amount of glucose in the blood of a person
can not be calculated due toit would be necessary to stir all the body’s blood turning it
impossible andimpractical. Whatis usually doneisto take asmall blood sample about
a deciliter at most, the glucose amount in this blood sample is measured {mg / dl} and, based
on this data to infer the total amount of glucose in the body.
Based on the above reasoning, with only three key data which are a blood volume of 60 in {dl},
healthy glucose concentration levels (CGS Meta) 100 {mg / dl} and healthy insulin
concentration levels (CIS Meta) 150 {mg / dl}, combined with the factors calculated in Table 3,
it is possible to apply this model to any other individual with a different high, weight and
gender. Obviously, the total amount of glucose and insulin in {mg} changes,
but not the value taken from the strings {mg / dl}.
Even for the case that a doctor would base ona different value about the healthy glucose
concentration (CGS Meta) in {mg / dl}, using the column of factors in Table3, it is possible to
recalculate the new concentration levels of the string in {mg/dl} and, to extrapolate the
calculation for this new condition. In this way t we expand the usage of the model.
Connection between glucose and insulin secretion.
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process ends. n a heathy human being, the insulin
secretion rises and decreases together with the
‘blood alucose concentration as the body recovers its
common harmony, also called homeostasis,
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11
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph: Insulin common secretion.
1000.00 Radio de Insulina Secrecién
Glucosa Normal
0.167 0.000
0.334 15.00
Insulina 0.500 85.00
Secrecién 0.667 190.00
Normal 0.833 350.00
1.000 500.00
1.167 665.00
1.333 925.00
1.500 930.00
1.666 975.00
8.000 1.833 995.00
DR
—— Radio_de_Glucosa Data Points: an
Edit Output:
[To Equation | {_DeleteGraph | [Cancel] [ok]
Insulin connection with the glucose usage of cells.
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nH vant rel estes of insulin | the glucose usage by
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the
release glucose and secrete insulin sped
between them as a result each system
determines the other's response.
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12
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph: Fraction of normal glucose utilization.
Radio de Fraccidn de uso
Insulina {1 min} normal
0.000 0.008
0.200 0.011
7 0.400 0.015
Fraccién de 0.600 0.019
uso normal 0.800 0.026
1.000 0.033
1.200 0.041
1.400 0.049
1.600 0.055
1.800 0.058
OCC) 2.000 0.059
Radio_de_Insulina {1/min} Data Points: 1
Edit Output:
[Te Equation | [{ DeleteGraph | [Cancel] [0K]
Homeostasis: Rate calculation of blood glucose release.
Glucosa
Saludable Pasta
Mi Peso Kgs o Lbs Factor Hiperglicosa Factor Umbral Renal Factor Hipoglucose:
1®) Experimento 2 os % ial a cee
siaeoy C)
rire wv Paso
Homeostasis () auve yee Se samen 8
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SS Sangre
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Homeostasis
.
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Ratio de Fraceisn de
Glucosa use normal that will maintain Geena
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— the gender, weight and high of every individual
insula od
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ak Zor ena! Saludable
~
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Hiperglucemia MG Ubmbral Renal MG Hipoglucemia MG
Insulng en
la Sangre
de Insulina
13
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Diabetes type I
Bic cL —aee
Saludablo
Exparimento 1
oe
Mi Peso Kgs 0 Lbs
Factor Hipergiucosa Factor Umbral Renal Factor Hipoglucesa
= ce é "26e8
Diabetos
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Te
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glucose level. The feedback |
Radio ée Fraccién de ‘mechanism glucose-insulin does
Pot Seeose vse noma ‘ot work
cease i Radio de Insuling | Diabetes type |
ena ; Indiabetes type |, beta calls secret
Insulina en Descompésicién just r il
| apse ES reese just a few or not insulin. Itis more
+ ‘commonly known as Juvenile
a ee
3 ‘commen in young people
Sectecién Ree
ce Insulina
is de
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Vo! DL
Lan
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Diabetes type II.
Exporimonte 2
Glucosa
Saludeble Pasta
”
Homeostasis
MiPeso
OQ
kgs 0 Lbs
—_ e)
Factor Hiperglucosa Facto: Umbral Renal Factor Hipaglucosa|
we CGS vs CGS,
r ~ Ce Vetun cad
oe = -
: ey Ronal
Feet ta le) O
mae ae casera; ate,
conPoste Next” \ Homeostasis per lao eéllas besa ie)
& ¥| Bt “63 In individuals with diabetes, the body cannot
Glucosa ‘Glceaen Diabetes | control the blood glucose level The
Libereda la Sangra Tipo | feedback mechanism glucose-insuiin does:
‘not work.
Fraccion
alable Radio de Fraccién de
R1 Indiabetes type Il, the pancreas secrets
itn Radio de sp Webb insuin at healthy levels but the body cells
eo eins ! Saludable ‘cannot take it because they d jontt respond
Normal insuinaen 3 cs ____ | correctly when the insulin drives them to
Te eee, Facto keep the glucose. This diabetes type is
rt - om ‘commonly called Diabetes of the Adult or
aes
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i os Hipsiglucem’s MG__Ubmbral Reral MG Hipeglucemia MG
14
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph: Fraction of glucose utilization in diabetes type II.
9.100 Radio de Fraccién de uso
Insulina {1 /min} Diabetes II
0.000 0.059
0.200 0.058
Fraccién de F 0.400 0.055
uso 0.600 0.043
Diabetes II 0.800 0.041
1.000 0.033
1.200 0.026
1.400 0.019
1.600 0.015
1.800 0.011
oe 2.000 0.008
Radio_de_Insulina {1/min} Data Points: 1
Edit Output:
{To Equation | [Delete Graph] [Cancel] [ok _}
Complete model of Diabetes.
Giuocea Mes Kgs oLbs FactorHiporclucosa Factor Umbral Renal Factor Hiooglucosa
Saludeble Pasta Ses Expetimenio 2 . “e668 vs CGS Ws CGS
oa Peso
ostans 9s Sube y Baie ature
. Volumen
; i éa) as Sangie (=)
er
Fraccion de
Un Dulce
us nora <a)
e Cual ces
Pasta cas es Glucosa utlizada Baas Hiperglucemia
con Postre Hones porlas caidas
*,
re 7 Se
€
CGS Teta
Gams hicosaen
bers ange
a Glucosa
Fraceln SaceHe!
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so normal (a) oe 1 ye Glucose OF
R1
Radio eo
—
Inculina
Secrecin
Normal
+, Insulin
aludabie
Inculina CIS Meta
de insulina
Tipo
ea
ay © de
vide dtl
Hiperglucemia MG = Ubmbral Renal MG ipoglucemia MG
Insulina en He On Factor Umbrai.Renal Seludable
B2 > . Factor Fipodcosa
Factor jucosa *\ Nee W306
(a) —) \
b
15
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
CGS Model ve amma
Tl Glucosa_en_la_Sangre(t) = Giucosa_en_a_Sangre(t- ot) + (Glicosa_Liverada- Glucosa_utlizada_por_las_células)* dt
INT Glucora anc Sangr rin(uenea Sludsle ig)
INFLOWS:
=% Glucosa_Liberads = Liverar_Glucosa {mg/min}
OUTFLOWS:
% Clucosa_uilizada_por_los_céluias = ifDiabotos_Tipo=2 then Glucosa_on_la_Sangro*Fraccién_do_uso_Diabotos_Ii {mg/min}
tise Glucose. Je Sangie"raci_de_use_sormal
[l insulina_en_ta_s n_la_Sangre(t- de_Insulina - |_de_Insulina) ot
INT inoulna_evla-Sanare=IntiulnaSaludabe) ma)
INFLOWS:
<2y Secrecién_de_Insuling =f Diabetes_Tipe=1 then 0
else Insulina_Secrecion_Normal
ourFLows:
de, 1-en_las )_de_vida_til {mg/min}
jon
Saat reneai se
caer ia Sanarenol DL (moldcitos)
}greWVol_DL_ {mgidecilros)
Suin'a_Saludable/vol_DL {mgialy
‘Cual_comida=3
Diatetes_Tipo = 0 {No Unidades,
Experimento_1 = GRAPHitime)
pe 129, 4000. son 0 e918). 770) eA, La a 20,940)
i, 0=ne}
©00000000
2
@ _Experimento_2 = GRAPHiti
oo. 200 429,416, (240, B40), (98., 55) 40.0, $20), (60.0, 640) (720, 65) (040,520) 060,480 (109, 85) (120,910)
Factor_Hiperglucos2_vs_CGS=2.1 {No Unidades}
= 0.40 {No Unidades}
90000
H(Radio_de_Insulina (1imin})
Koon. 0.059), (0.2, 0.058), (0.4, 0.055), (0.6, 0.049), (0.2, 0.041), (4.00, 0.033), (1.20, 0.026), (1.40, 0.019) (1.60, 0.045), (1.89, 0.011), 200, 0.008)
Fraccidn_de_uso_normial = GRAPH(Radio_de_Insulina¢1!miny)
(0.00, 0.0076), (0.2, 0.0108), (0.4, 0.0148), (0.6, 0.019) (0.8, 0.0258), (1.00, 0.033), (1.20, 0.0405), (1.40, 0.049), (1.80, 0.0546), (1.80, 0.0878), (2.00, 0.059)
‘© Género = 1 {1=hombres, O=mujeres No unidad)
© Glucosa_Saludable = Vol_DL*CGS_Meta {mg}
© Hiperglucemia = CGS_Meta*Factor_Hiperglucosa_vs_CGS {mg/dl}
Hiperglucemia_MG = Factor_Hiperglucosa_vs_CGS*Glucosa_Saludable
© Hipoglucemia = CGS_Meta*Factor_Hipogluc
s0Sa_vs_CGS {mg/dl}
8 Hipoglucemia_MG = Factor_Hipogiucosa_vs_< Cossctcosa Ssivdaio
1 de
8 Insulina_Saludable = Glucosa_s Sasa serie vs, Cima 1_OK {mg}
@ _Insulina_Secrecién_Normal = GRAPH(Radio_de_Glucosa)
pao 0.00), (0.334, 15.0), ‘os 85.0), (0.867, 190), (0.833, 350), (1, 500), (1.17, 665), (1.33, 825), (1.50, 930), (1.67, 975), (1.83, 995)
© Kgs_o_Lbs = 4 {kg=1, Ibs=0}
© Liberar_Glucosa = Gate) Homeostasis=1 then Homeostasis {g/min}
else
if Cual_comida=1 then Homeostasis {mg/min}
else if Cual_comida=2 then Un_Dules
else if Cual_comida=3 then Tres_Dulces
It 1=7 then Experimento_1
else Experimento_2
© Mi_Peso= 105. Rasa Kg}
@ Pasta = GRAPH(tim:
ee 00, 400), (12.0, 400), (24.0, 400), (36.0, 400), (48.0, 400), (60.0, 400), (72.0, 400), (84.0, 400), (96.0, 400), (108, 400), (120, 400)
@ Pasta_con_Postre = GRAPHitime!
[n° (00, 198), (12.0, 300), (24.0, 380), (38.0, 400), (48.0, 400), (60.0, 370), (72.0, 705), (84.0, 800), (96.0, 800), (108, 305), (120, 198)
Q Peso =ifkgs_o_Lbs=1 then Mi_Peso else Mi_Peso/2.204 {kg}
O Radio_de_Glucosa Glucosa_en-la_Sangre/Gcosa Sena) uae
© Radio_de | =
‘Sube_y_Baja = GRAPH
(0.00, 400), (12.0, 400), (240, 400), (36.0, 100), (48.0, 100), (60.0, 100), (72.0, 100), (84.0, 100), (96.0, 100), (108, 100), (120, 100)
© Tiempo_de_vida_uitil = 18 {min}
@ Tres_Dulces = GRAPH(time)
(0.00, 198), (12.0, 900), (24.0, 400), (38.0, 295), (48.0, 400), (60.0, 900), (72.0, 400), (84.0, 295), (96.0, 400), (108, 900), (120, 198)
©. Ubmbral_Renal_MG = Factor_Umbral_Renal_vs_CGS*Glucosa_Saludable
© Umbral_Renal = CGS_eta"Facor_Umbral Renal. ss_C6S (mai
@ un_Dulce =
00. 190, 120, 108) (24.0, 900 (98.0, 196), (48.0, 196, (60.0, 186), 720, 198), 240, 498), 060, 198), 108,198) 120,196)
© Volumen_Sangre = if Género=1 then (1= hombres,
}669"Altura’3 + 0.03219*Peso + 0.6041
else 0.3561"Altura*3 + 0.03308*Peso + 0.1833 {its}
=mujeres}
16
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Data specification to start the simulator.
Length of simulation:
aes (]
To: 120
oT: 4.00
Pause
interval INF
Integration Method
@ Euler's Method
Runge-Kutta 2
© Runge-Kutta 4
[7 Analyze Mode: stores run resuits in memory ( 0.0 MB required )
Unit of time: Fun Mode
2 Hours © Normal
Days Cyclesime
ess Interaction Mode:
Months Nomnal
Quarters © Flight Sim
Years
© Other
Minutes
Sim Speed:
0.05 fealsecs = 1 unit time
Min run length: 6 secs
Came)
Graphic results of the model to a healthy person.
Case 1: Eating simple sugar, a candy or chocolate bar.
Eating a candy bar will release a significant amount of glucose into your bloodstream giving
you what is often called a "high-sweetened".
To give you an idea, a typical candy bar contains about 30 grams (30.000 mg) of simple sugar.
To drink regular soda (not diet) of 12 ounces contains 41 grams of sugar.
The digestive system moves rapidly the simple sugar into the bloodstream. A candy ora
sodacan be totally absorbed ina time of 20to 30 minutes. How, do you think, should
be the graph behavior of the blood glucose and insulin concentration after eating the candy?
Rate release of blood glucose when eating a candy {mg / min}
1S) ‘unction: 1:38]
7000.00
Minutes Un Dulce
f\ 0.000 198.00
dey 12.00 198.00
ry 24.00 00.00
Un Dulce 36.00 198.00
12h 48.00 198.00
pet 60.00 198.00
72.00 198.00
84.00 198.00
96.00 198.00
703,00 198.00
Get i 120.00 198.00
{120.00}
Minutes DataPoints: 11
Edit Output
[Te Equation Delete Graph (ice!
Eating a candy - Rate release of blood glucose {mg / min}
Below, in conjunction with the
graphs that show the
behavior of blood glucose conc
entration in {mg /dl}, there are
also the glucose bands or
conditions to easily
visualize when our health is in
danger. Similarly we’ll show
what happens with the
concentration of
insulin {mg / dl}. The results are
also plotted in {mg}.
17
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Page 1 - Graph of blood glucose concentration in {mg / dl} eatinga
candy.
@ © ccs iets 2: CGS 2: Hipogiucemis 4: Umbral Renal 5: Hiperglucemia
1 $ODa 280s sos ere ees A aes roam tas tanga,
2
3:
4
1
2
3
4
1 4,
2
3
‘
P 00 0.00 60.00 90.00 120.00
Page t Minutes 1:18 PM Fri, Sep 03, 2010
Naat ? Conoentraciién de Glucosa en la Sangre (CGS) {mg/dl}
Figure 1: Page 1 - Graph of blood glucose concentration in {mg / dl} eating a candy.
It is really interesting that we have the opportunity to compare the glucose behavior in
conjunction withthe condition of glucose stripesthat can help us to visualize potential
problems, asin this case, the renal threshold is exceeded by minutes, the kidneys cannot
respond as they should and glucose could starts spilling by the urine. The impact caused
by a simple candy in the organism is alarming.
Graph of the total amount of blood glucose {mg}.
Ubmb...Renal MG 5: Hiperglucemis MG
(@ 1: Glucosa Saludable 2: Gluco... ls Sangre 2: Hipoglucemia MG
*.0 60.00 90.00 120.00
lage 4 . Minutes: 1:16 PM Fri, Sep 03, 2010)
\aeF 7 Nivel de Glucosa en Ia Sangre {mg}
Figure 2: Page 4 - The level of the total amount of blood glucose {mg}, when eating a candy.
18
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph of the glucose-insulin concentration in blood {mg / dl}.
1 te 2: 32¢ ta 4: Cl
CGS Met 2: CGS 3: CIS Met cis
| ws
0.00 30.00 60.00 $0.00 120.
Minutes 11:42 AM Mon, Sep 08, 2010
? Concentraciién de Glucosa Insulina en ls Sangre (CGS) {mg/l}
Figure 3: Page 7 - insulin glucose concentration in blood {mg / dl} when eating a candy.
Graph of the total amount of blood glucose-insulin {mg}.
9 1: Glucosa Saludable 2: Glucosa en la Sangre 3: Insulina Ssludable 4: Insulina en la Sangre
1 DRBOB en ccevre sere cannunrecwngincuaxancmaceneriawnensnny Vaenneup ounce irdeNen er meee tucmaanalneates
; |
3:
4
1
r
A |
i
1
2
4 |
4
0 30.00 60.00 30.00 120.00
age 8 Minutes 11:28 AM Mon, Sep 08, 2010]
Jae ? Nivel de Givooss e Insulina en la Sangre {ma}
Figure 4: Page 9 total amount of blood glucose —insulin {mg}. When eating a candy.
19
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Case 2: Eating 3 candy bars.
Rate release of blood glucose when eating 3 candies {mg / min}
1000.00 .
Minutes Tres Dulces
0.000 138.00
12.00 900.00
24.00 400.00
Tres Dulces 36.00 295.00
48.00 400.00
60.00 900.00
72.00 400.00
84.00 235.00
96.00 400.00
108.00 900.00
0.000 120.00 198.00
Minutes Data Points: an
Edit Output:
[. ToEquation | [ DeleteGraph | [Cancel] [_ OK}
Figure 5: Rate release of blood glucose when eating 3 candies {mg / dl}
Graph of Rate release of blood glucose {mg / dl} when eating 3 candies.
@ +: CGS Mets 2: CGS 2: Hipoglucemis 4: Umbral Renal 5: Hipergluoemis
1 SOO ig? coscees sav vienusccruggeceesanlane Ae be dumagacar sata lemiele veuacntene Nariiieieany
\2:
B
i
iM
le
B
4
be
It
lz
3:
re
IE
00 20.00 60.00 90.00 120.00
lage 1 Minutes 2:43 PM Fri, Sep 03, 2010]
Jaet ? Concentraciién de Glucosa en la Sangre (CGS) {mg/dl}
Figure 6: Blood glucose concentration {mg/dl,} eating 3 candies.
20
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph of Candies - Blood concentration of Glucose-insulin
@ + CCS Mets ces 3: CIS Meta 4: CIS
1 200.
2
3
4
z 1504 ™ oS fo
2 2
4 ad > a4
LZ
,
2
3
4
. 0.00 60.00 90.00 120.00
Page 7 Minutes 11:29 AM Mon, Sep 08, 2010
\aeF ? Concentraciéon de Glucosa e Insulina en la Sangre (CGS) {mg/dl}
Figure 7: Blood glucose-insulin concentration {mg / dl}, when eating 3 candies.
Case 3: Eating complex carbohydrates as pasta and thena
delicious dessert
Foods like beans, rice, oats and other cereal grains, flesh fruits, vegetables, bread and
pasta, contain combined sugars and starches. Digestion turns on these complex
carbohydrates into glucose in a more equilibrated speed the rapid absorption of
simple sugars. In this occasion, we will simulate the body's response toa pasta
meal, followed by a delicious dessert.
© os = |!The rate release of blood
1000.00 reap ree glucose of pasta is not as
high as that of a candy, it might
200 mo remain stable at 400 {mg/ min}
— ue ae as shown in this data.
43.00 400,00
400.00
7200 400.00
400.00
400,00
108.00 400.00
120.00 400.00
Fi20.00)
Minutes Data Points: n
Edit Output:
(Tetmatin _] [_DesteGresh ) [Gonos } (om)
Figure 8: Rate release of blood glucose of the pasta {mg / min}.
21
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Rate release of blood glucose of the pasta and the dessert {mg / min}.
(Graphical Finer xa
5
7000.00
Minutes Pasta con Postie
000 798.00
\ 12.00 300.00
} \ 24.00 360,00
Pasta con 36.00 400.00
Postre \ 48.00 400.00
60.00 370.00
72.00 705,00
84.00 800.00
96.00 800.00
108.00 305.00
ad 1 120.00 498.00
7 7
| Yy 0.000
J Minutes DataPoints: 11
Edit Output:
{Te Equation} { DeleteGraph | {Cancel} [OK]
Figure 9: Data for the rate release of blood glucose when eating a pasta and dessert in {mg / dl}.
Graph of Blood glucose concentration when eating pasta and dessert
{mg / dl}.
@ 10S Meta 2: CGS 2: Hipoglucemis 4: Umbral Renal §: Hiperglucemis
1 Geass Creer eae RS eee
2:
§
1
2:
3 1504
|
1
2 2
|
4
0 20.00 60.00 $0.00 120.
age 1 Minutes 5:53 PM Fri, Sep 03, 2010}
N aeaF 7? Concentraciién de Glucoss en la Sangre (CGS) {mg/dl}
Figure 10: Blood glucose concentration when eating pasta and dessert {mg / dl}.
How impressive is the impact onthe rising blood glucose concentration. Fora while, the
band reaches to the hyperglycemia that would cause extensive damages to our bodies. How
many times have we eaten dessert twice and then having some ice cream and some cups
of coffee without being awareofwhat is happening inside of our bodies? Who would
imagine that only 30 grams of sugar from asingle candy bar would cause all this within us!
How many times we've eaten whole bags of candy? It is desperately important to be conscious
about it and to reflect on diabetes prevention.
22
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graphic about blood concentration of glucose-insulin when eating
pasta and dessert. {mg / dl}
s 1: CGS Meta 2: CGS 3: CIS Meta 4cIs
1]
Pat
—
i Pa Pad mo™
“ oo N
|
4
00 W.00 60.00 90.00 120.0
Page 7 ° ‘Minutes 12:38 PM Mon, Sep 06, 2010}
NJ a & ya < ‘gin de Glu GS) Sangre {mg/dl}
Graphic results of a model in a person with diabetes, eating pasta and dessert.
| do not want to imagine what would happen with a diabetic person (type | or II) who takes a
similar meal like the one already shown. In individuals with diabetes, the body cannot control
the blood glucose level. The feedback mechanism glucose-insulin does not work.
Diabetes type I.
In diabetes type |, beta cells secret just a few or not insulin. It is more commonly known as
Juvenile diabetes because it is more common in young people.
Graph of Blood glucose concentration when eating pasta and dessert
{mg / dl} - Diabetes I
@ ooo hew 2:cGS 2: Hipoglucemia 4: Umbral Renal =: Hipergiucemia
1
|
3
4
7 Fa
1
2 LL
3 r
F aa
00 30.00 60.00 30.00 120.
lPage 1 Minutes 6:24PM Fri, Sep 03, 2010]
Neat ? Concentraciién de Giuoosa en la Sangre (CGS) {mg/dl}
23
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph of Blood glucose-insulin concentration {mg / dl} - pasta and
dessert - Diabetes I
@ 1: CGS Mets 26S 2: CIS Meta 4:CIS
SRS
sans
~~, |
00 2.00 60.00 90.00 120.0
Minutes 12:36 PM Mon, Sep 08, 2010)
jage 7 ‘
JaeF ? ‘Concentraciién de Glucoss (CGS) e Insulina (CIS) en is Sangre {mg/h
A
Asa kid | had friends in my hometown M. Muzquiz, Coahuila, who had diabetes and injected
themselves insulin every day, now! understand why they did it. It is clearly shown in Figure
14 that the insulin is not secreted by the pancreas in diabetes type |. 40 years ago we had just
little information about this disease. When insulin is not secreted in a natural form, then it
must be obtained from external fonts.
Diabetes type II.
In diabetes type II, the pancreas secrets insulin at healthy levels but the body cells cannot take
it because they don’t respond correctly when the insulin drives them to keep the glucose. This
diabetes type is commonly called Diabetes of the Adult or non-insulin-dependent diabetes
mellitus.
Graph of Blood glucose concentration when eating pasta & dessert
{mg / dl} - Diabetes II
@ ‘cosets —_2.c08 2: Hipogiucemia 4: Umbral Renal &: Hipergucemia
| a
oO W.00 60.00 90.00 120.
Page t Minutes 6:58 PM Fri, Sep 03, 2010)
3eaF ? Concentraciién de Giuooss en Is Sangre (CGS) {mgs}
24
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Graph of Blood glucose-insulin concentration {mg / dl},, pasta and
dessert-Diabetes II
@ 1: CGS Mets 2: CGS 3: CIS Meta 4: CIS
IN; 300.
|
[2
ft
Cs) 00 60.00 90.00 120.00
Minutes 11:50 AM) Mon, Sep 08, 2010]
bae 7 :
JaeaF ? Concentraciién de Glucosa (CGS) e Insulina (CIS) en la Sangre {mg/dl}
Now it is very clear to me that for diabetics type Il, the problem is not the lack of insulin,
as shown in Figure 16, insulin is secreted normally. The problem is founded inthe cells that
rejectinsulin, avoiding the brought help to use glucose, adding to this the insulin
accumulation. Reason why theremust be a special care, because both deficiency
are harmful to health.
Facts that a diabetic should take into account.
A diabetic who has not taken enough insulin or whose cells are resistant to insulin is essentially
starving because glucose (the principal source of energy) can not enter into the body cells. A
diabetic who injects him/herself too much insulin, causes the glucose excess entering into the
cells (type 1) or an insulin excess is accumulated in the blood (type 2).
Any of these conditions can lead the person to serious consequences for the physical life as the
diabetic coma. Managing diabetes requires a special attention to the body's response of the
different blood glucose levels to maintain homeostasis.
Lifestyle changes.
What changes would you make in your lifestyle if you were diagnosed with diabetes type 1 or
type 2?
1. Exercise more to use more glucose.
2. Do not eat simple sugars. Eliminate candy bars, chocolates and regular sodas.
3. Eat complex carbohydratessuch as_ fruits, vegetables, pastaand processed
foods elaborated with whole grains or whole wheat flour.
4. Eat a variety of foods that take more time to be absorbed.
25
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
5. Eat small amounts of meal at frequent intervals, for a constant supply of glucose.
New study areas to experiment.
Our model contains more study cases already prepared. Also there have been added two more
for the user to experiment with different meals and observes the impact over the time of the
behavior in the blood glucose concentration of insulin.
Diabetes learning lab - in Stella 10 (English)
By Ing. Pedro D. Almaguer Pra
‘Ago 2010
Collaborators:
g Lic. Beatriz E. Navarro Vazquez
e Lic. Pedro D. Almaguer Navarro.
Lic. Ramiro L. Almaguer Navarro.
GRUPO SINAPSYS
Designed by:
[ Gepiacingm dpa] Lic. Ruth R. Almaguer Navarro.
26
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Food Wodel Homeostasis Simulation
DIABETES Cause-effect cycles
Information glucose, insulin and the role of the ‘Istimulates the
Pancreas. * glucose uptake
Diabetes Food Model Homeostasis Simulation
DIABETES - calculation parameters {mg/dl} [Concentration of glucose inthe blood (mais) |
Insulina Secrecién Fraccién de uso
Diabetes I!
@® cnupo sinapsys
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Diabetes Parameters Homeostasis Simulation
RELEASE OF BLOOD GLUCOSE {mg/min}
12
2011
come FP
fae
Diabetes Parameters Homeostasis Simulation
DIABETES MODEL [Glucose Level (ma) | [ Complete mod! | ["todei Cos]
eeocosg SS ==
‘
eee et |
;
igh glucose level == N
— =]
individual blood volume: ] H
_ z
rs ao oo eo =a
Tao eked anges P22 ions {938A sa, warts 204
Bee INGE? Nivel ge Glucose Inauins en ls Sangre imal
Bands {mg}
Togegueena us | 128007]
Tent Rena] 9800]
==
[irra ERA]
=a
Qeneen =o
28
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Diabetes Parameters Food Model Simulation
| ]
HOMEOSTASIS eeoeceo
beusteaul| fun | Pace | stor
What i iE Calculate Homeostasis [TF]
@ vccsua aces 2 Wpephoamie 4: Umbra: pergucame
3]
:
:
4]
: ~
4 ot XN
4
i
:
Hi
ry mabe aise wo ey
: Mates 029A Sat. ar 18, 205
aeF 2? Homeostasis (mos)
For an individual with a blood volume: Decilitros (al)
To achieve the required level {mg/min}
homeostatic a glucose release rate of:
betes Parameters Food Model Homeostasis
e
ese)
stor
GLUCOSE CONCENTRATION IN THE BLOOD (GCB) {mg/dl}
e
Datos individuales del paciente:
(azGender | (DRT | Female orate
{instructions l
a eae ae
Cambiar de pagina
ee) ch {mg/at)
29
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Conclusions
What an_ interesting model andits learning laboratoryto help our young people
to understand in a better way the health impact of diseases such as diabetes. The positive way
in which the teaching work can lead to new habits and lifestyles in prevention of
diseases that can bring down the life quality of our people and our public health systems.
It has been the Diabetes turn. Developing its model to understand better what happens with
the mechanisms of self-regulation control and the blood glucose level, show us what is healthy
and what is not for our body. Our wellbeing depends on the release rate of glucose
entering the bloodstream during digestion.
Once the food is converted into glucose, it is important to visualize the cause-effect cycles that
underlie the disease and its connection to other organs. Pancreas and insulin secretion, liver,
bloodstream, which transports into cells the energy that glucose brings them, kidneys needed
to release the glucose excess in urine, the hormonal system, etc. Forming together the
negative feedback cycles responsible for regulating the blood glucose level to avoid severe
damages to our body.
Using our learning lab, ouryouth willhave theopportunity for experiencing what
happensinside ourbodiesat the intake of different meals, what happens when
the renal threshold bands andhyperglycemia are exceeded, orwhen hypoglycemia is
presented, as well they would understand better how these cycles are broken by diseases like
diabetes type | and II and the balance and harmony within us is disrupted.
The mostimportant fact is to be proactive in the prevention task,to work in the
appropriate time to change their habits and lifestyles improving their nutrition. It is also
remarkable the importance of exercising when an individual suffers the disease. The glucose is
in an excessive amount due to insulin isnotsecreted and it must be eliminated
(Diabetes Type I) or even when having insulin and the cells reject it (diabetes type Il),
therefore glucose should leave and the best way to eliminate it is exercising.
Finally, returning tothe old dynamiccontrolclass received since more than30 years
ago connected withthe development of thislearning laboratory for diabetes, it would
be interesting toapplythis knowledge in future worksto model the behavior of other
regulatory mechanisms such asthe body temperature control, the heart rate, the
water amount contained inthe blood and breathing. Allof these systems share similar
structures like cause-effect cycles with negative feedbacks mechanisms that allow homeostasis
and regularizes any changes in the parameters of a healthy person.
30
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Bibliography
Alcohol en el sistema sanguineo [Publicacién periédica] / aut. Almaguer Prado Pedro
Dagoberto, Almaguer Navarro Ruth Raquel y Almaguer Navarro Ramiro Luis. - Monterrey, N.L.,
México : [s.n.], 2010.
Alcohol in Your Body [Publicacién periddica] / aut. Dance Rosalie A. y Sandefur James T.. -
1998.
Biology Online [En linea] // http://www.biology-
online.org/4/1_physiological_homeostasis.htm. - 16 de Agosto de 2010.
Calculadoras de volumen de sangre [En linea] //
http://es.easycalculation.com/medical/blood-volume.php. - 25 de Agosto de 2010.
Homeostasis [En linea] // http://www.biologymad.com/resources/A2%20Homeostasis.pdf. - 1
de Agosto de 2010.
How Long Does It Take To Get Drunk? [En linea] / aut. Johnson Nicole y Ha Mon.
Lecci en Aticas un enfe dinamico [Libro] / aut. Fisher Diana M.. - [s.I.] : Stella
Software, 2008. - Vol. Guia Docente.
Maryland Virtual High School of Science and Mathematics [En linea] / aut. Hartlove Janet,
Shaffer Don y Ragam Susan // http://mvhs1.mbhs.edu/mvhsproj/glucose/glucose.html. -
Glucose-Insulin Model. - 15 de Agosto de 2008.
Meets the Market [Informe] / aut. Michaelis-Menton. - 1999.
Students Taking a Systems Approach to Drinking and Driving [Publicacién periddica] / aut.
Yerger Stephany. - 1999. - La Salle High School Milwaukie, Oregon.
System Dynamics Models Created by High School Students [Publicacién periddica] / aut.
Fisher Diana M.. - Portland, Oregon USA : [s.n.], 2000.
Systems thinking and system dinamics in the CC-Stadus High School project (How High
School students become system thinkers) [Publicacién periddica] / aut. Fisher Diana y Guthrie
Scott.
Wikipedia [En linea] // http://en.wikipedia.org/wiki/Blood_sugar_regulation. - Blood sugar
regulation. - 20 de Agosto de 2010.
31
SYSTEMS THINKING
Diabetes: Glucose concentration level in blood
Details of the author and collaborators:
Autor’s Name: Almaguer Prado, Pedro Dagoberto
Place of birth: MUzquiz, Coahuila, México.
Education: Ingeniero Quimico y de Sistemas (ITESM) 1980
(Chemical Engineering and Systems)
Professor: As student he taught mathematics at a professional level in
the Mathematics Department ITESM 1979-1980. Professor of Chemical
Engineering Department ITESM 1980-1985.
I http://www.gruposinapsys.com
E-mail: pedrodago@ gmail.com
Collaborator: Pedro Dagoberto Almaguer Navarro
Education: Licenciado en Mercadotecnia
Email: pan.dago82@gmail.com
Modeling: Ramiro Luis Almaguer Navarro
Education: Licenciado en Administracién de Empresas
Email: rmalmaguer@gmail.com
Design: Ruth Raquel Almaguer Navarro
Education: Licenciada en Disefio Grafico (Graphic Design)
Email: ruth_ran@hotmail.com
Collaborator: Beatriz Eugenia Navarro Vazquez
Education: Licenciado en Comercio Internacional (International Trade
Degree)
Email: bety.5505@gmail.com
Db Dz
Translator: Merari Sarai Trejo Medellin
Education: Licenciada en Teologia
Email: merari.trejo@gmail.com
32:
