[en] Extending safe, effective glycemic control to the general wards requires a simple approach using subcutaneous (SC) insulin. However, this approach can increase relative risk compared to intravenous insulin due to the increased variability of SC insulin appearance. This paper evaluates the accuracy of a SC plasma insulin model and optimizes its parameters using measured plasma insulin data from 6 less acute critical care patients treated with SC insulin. The SC plasma insulin model used captures the dynamics of regular SC insulin well. However, there appears to be a positive bias leading to an overall median [IQR] residual error of -28.3 [-37 - 19] mU/L. The optimized model reduced the RMS residual error by 20-70% for each patient. The distinct inter- and intra-patient, and cohort variation seen in this data highlights the importance to of understanding how SC insulin appearance dynamics may be affected by the subject condition.
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Bibliography
Capes, S.E., Hunt, D., Malmberg, K., Gerstein, H.C., Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: A systematic overview (2000) Lancet, 355, pp. 773-778. , Mar 4
Van Den Berghe, G., Wouters, P., Weekers, F., Verwaest, C., Bruyninckx, F., Schetz, M., Intensive insulin therapy in critically ill patients (2001) N Engl J Med, 345, pp. 1359-1367. , Nov 8
Mizock, B.A., Alterations in fuel metabolism in critical illness: Hyperglycaemia (2001) Best Pract Res Clin Endocrinol Metab, 15, pp. 533-551. , Dec
McCowen, K.C., Malhotra, A., Bistrian, B.R., Stressinduced hyperglycemia (2001) Crit Care Clin, 17, pp. 107-124. , Jan
Bistrian, B.R., Hyperglycemia and infection: Which is the chicken and which is the egg? (2001) JPEN J Parenter Enteral Nutr, 25, pp. 180-181. , Jul-Aug
Lin, J., Lee, D., Chase, J.G., Shaw, G.M., Le Compte, A., Lotz, T., Stochastic modelling of insulin sensitivity and adaptive glycemic control for critical care (2008) Computer Methods and Programs in Biomedicine, 89, pp. 141-152. , Feb
Chase, J.G., Shaw, G.M., Lin, J., Doran, C.V., Hann, C., Lotz, T., Targeted glycemic reduction in critical care using closedloop control (2005) Diabetes Technol Ther, 7, pp. 274-282. , Apr
Evans, A., Le Compte, A., Tan, C.S., Ward, L., Steel, J., Pretty, C.G., Stochastic targeted (STAR) glycemic control: Design, safety, and performance (2012) J Diabetes Sci Technol, 6, pp. 102-115. , Jan
Hovorka, R., Kremen, J., Blaha, J., Matias, M., Anderlova, K., Bosanska, L., Blood glucose control by a model predictive control algorithm with variable sampling rate versus a routine glucose management protocol in cardiac surgery patients: A randomized controlled trial (2007) J Clin Endocrinol Metab, 92, pp. 2960-2964. , Aug
Kulnik, R., Plank, J., Pachler, C., Wilinska, M.E., Groselj-Strele, A., Rothlein, D., Evaluation of implementation of a fully automated algorithm (enhanced model predictive control) in an interacting infusion pump system for establishment of tight glycemic control in medical intensive care unit patients (2008) J Diabetes Sci Technol, 2, pp. 963-970. , Nov
Aragon, D., Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control (2006) Am J Crit Care, 15, pp. 370-377. , Jul
Carayon, P., Gurses, A.P., A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units (2005) Intensive Crit Care Nurs, 21, pp. 284-301. , Oct
Gartemann, J., Caffrey, E., Hadker, N., Crean, S., Creed, G.M., Rausch, C., Nurse workload in implementing a tight glycaemic control protocol in a UK hospital: A pilot time-in-motion study (2012) Nurs Crit Care, 17, pp. 279-284. , Nov-Dec
Malesker, M.A., Foral, P.A., McPhillips, A.C., Christensen, K.J., Chang, J.A., Hilleman, D.E., An efficiency evaluation of protocols for tight glycemic control in intensive care units (2007) Am J Crit Care, 16, pp. 589-598. , Nov
Berger, M., Cuppers, H.J., Hegner, H., Jorgens, V., Berchtold, P., Absorption kinetics and biologic effects of subcutaneously injected insulin preparations (1982) Diabetes Care, 5, pp. 77-91
Evans, A., Le Compte, A., Tan, C.S., Ward, L., Steel, J., Pretty, C.G., Stochastic Targeted (STAR) Glycemic Control: Design, Safety, and Performance (2012) Journal of Diabetes Science and Technology, 6, pp. 102-115
Lin, J., Razak, N.N., Pretty, C.G., Le Compte, A., Docherty, P., Parente, J.D., A physiological intensive control insulin-nutrition-glucose (ICING) model validated in critically ill patients (2011) Comput Methods Programs Biomed, 102, pp. 192-205. , May
Fisk, L., (2014) Model-Based Decision Support in Glycaemic Control, , Doctor of Philosophy, Mechanical Engineering, University of Canterbury University of Canterbury
(1999) Insulin Aspart Clinical Pharmacology and Biopharmaceutics Review (S, , Food and Drug Administration, Center for Drug Evaluation and Research
Berger, M., Halban, P.A., Girardier, L., Seydoux, J., Offord, R.E., Renold, A.E., Absorption kinetics of subcutaneously injected insulin-evidence for degradation at the injection site (1979) Diabetologia, 17, pp. 97-99
Pretty, C.G., Le Compte, A.J., Chase, J.G., Shaw, G.M., Preiser, J.C., Penning, S., Variability of insulin sensitivity during the first 4 days of critical illness: Implications for tight glycemic control (2012) Ann Intensive Care, 2, p. 17
Similar publications
Sorry the service is unavailable at the moment. Please try again later.
This website uses cookies to improve user experience. Read more
Save & Close
Accept all
Decline all
Show detailsHide details
Cookie declaration
About cookies
Strictly necessary
Performance
Strictly necessary cookies allow core website functionality such as user login and account management. The website cannot be used properly without strictly necessary cookies.
This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.
Performance cookies are used to see how visitors use the website, eg. analytics cookies. Those cookies cannot be used to directly identify a certain visitor.
Used to store the attribution information, the referrer initially used to visit the website
Cookies are small text files that are placed on your computer by websites that you visit. Websites use cookies to help users navigate efficiently and perform certain functions. Cookies that are required for the website to operate properly are allowed to be set without your permission. All other cookies need to be approved before they can be set in the browser.
You can change your consent to cookie usage at any time on our Privacy Policy page.
