Unraveling the Impact of Carbohydrate Intake: A Causal Mediation Analysis of T1DM Glucose Dynamics

Music City Center 

Effective glycemic control in Type 1 Diabetes Mellitus (T1DM) depends on understanding the complex interplay between carbohydrate intake, insulin administration, and blood glucose levels. This study investigates the causal pathways linking meal timing to postprandial glucose levels, focusing on the direct effect of carbohydrate intake and the indirect effect mediated by bolus insulin. Using the OHIO T1DM dataset, which includes continuous glucose monitoring, insulin administration, and detailed meal records, we apply Causal Mediation Analysis (CMA) to quantify these effects. We estimate the Average Causal Mediation Effect (ACME) of bolus insulin and the direct effect of carbohydrate intake at both the individual level and across different times of the day. To account for potential confounders, we fit mediator and outcome models that incorporate pre-treatment measurements and employ Inverse Probability of Treatment Weighting (IPTW) to balance covariates across time-of-day categories (morning, afternoon, evening, late evening). Finally, we assess whether these causal effects vary by time of day, providing new insights into the temporal dynamics of T1DM management.

Causal Mediation Analysis

Type 1 Diabetes Mellitus

OHIO T1DM data set

Time-Varying Effects

Factors Influencing Blood Glucose 

Section on Medical Devices and Diagnostics