Vol 123, No 1 (2018)
Original Article

A mathematical model appraising the effect of metabolic control on joint mobility in young diabetic patients: a preliminary study

Piergiorgio Francia
Dept. of Clinical and Experimental Medicine, University of Florence, Italy
Barbara Piccini
Diabetes Unit, Meyer Children’s Hospital, Florence, Italy
Massimo Gulisano
Dept. of Clinical and Experimental Medicine, University of Florence, Italy
Sonia Toni
Diabetes Unit, Meyer Children’s Hospital, Florence, Italy
Leonardo Bocchi
Dept. of Information Engineering, University of Florence, Italy

Published 2018-04-09

Keywords

  • Diabetes mellitus type 1,
  • glycemic control,
  • joint mobility

How to Cite

Francia, P., Piccini, B., Gulisano, M., Toni, S., & Bocchi, L. (2018). A mathematical model appraising the effect of metabolic control on joint mobility in young diabetic patients: a preliminary study. Italian Journal of Anatomy and Embryology, 123(1), 23–31. Retrieved from https://oajournals.fupress.net/index.php/ijae/article/view/1611

Abstract

Objective. The impairment of glycemic control can induce limited joint mobility even in young type 1 diabetic (T1DM) patients. The aims of this study were to verify the presence of ankle joint mobility (AJM) deficits in young T1DM subjects and define a mathematical model of diabetes mellitus long-term effects on AJM. Methods. AJM was evaluated using an inclinometer in 37 patients and 53 healthy, sex- BMI- and age-matched controls. To set up the mathematical model, we assumed that reduced metabolic control affects AJM according to a lognormal function: requiring some time for development of a reduction of joint mobility, which then persists for a long period, before fading out over time (if glycemic control has been recovered). A non-linear optimization determined the model parameters to achieve the best fit for a series of patients. Results. Both plantar and dorsiflexion AJM was significantly lower in diabetic subjects than in controls (plantarflexion: 28.5°±7.5 vs 35.2°±6.5; dorsiflexion: 93.9°±16.0 vs 104.7±12.8; p<0.01). The defined model approximates the experimental data with good accuracy; after optimization, the lognormal curve obtained is in line with empirical estimates: lack of glycemic control needs to persist for at least a few months before producing a significant effect, that lasts up until one year. The fitting procedure indicated the optimal solution is p = (37; 30; 3:5; 6:7; 137); thus, the optimal _im(t) corresponds to the curve reported. Conclusion. AJM was significantly reduced in young T1DM patients. The mathematical model represents the experimental data accurately.