Models of subcutaneous insulin kinetics. A critical review.

Subcutaneous insulin kinetics is a complex process whose quantitation is needed for a reliable glycemic control in the conventional therapy of insulin-dependent diabetes. The major difficulties in modeling include accounting for the distribution in the subcutaneous depot and transport to plasma. A single model describing in detail the various processes for all the commercially available insulin preparations is not available. Several models however have been proposed which vary in the degree of complexity. Virtually all of them handle the regular insulin preparation while a few handle the intermediate acting and the novel insulin analogues. In this paper we critically review these models.