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Delay-induced uncertainty for a paradigmatic glucose-insulin model.

Medical practice in the intensive care unit is based on the assumption that physiological systems such as the human glucose-insulin system are predictable. We demonstrate that delay within the glucose-insulin system can induce sustained temporal chaos, rendering the system unpredictable. Specifically, we exhibit such chaos for the ultradian glucose-insulin model. This well-validated, finite-dimensional model represents feedback delay as a three-stage filter. Using the theory of rank one maps from smooth dynamical systems, we precisely explain the nature of the resulting delay-induced uncertainty (DIU). We develop a framework one may use to diagnose DIU in a general oscillatory dynamical system. For infinite-dimensional delay systems, no analog of the theory of rank one maps exists. Nevertheless, we show that the geometric principles encoded in our DIU framework apply to such systems by exhibiting sustained temporal chaos for a linear shear flow. Our results are potentially broadly applicable because delay is ubiquitous throughout mathematical physiology.