[en] Introduction:
Sex differences in the metabolic response to critical illness are unknown. This retrospective analysis examines
potential differences in the evolution of insulin sensitivity (SI) and its variability (%ΔSI) between sexes.
Significant differences would suggest differences in the metabolic stress response and glycaemic response to
insulin therapy, and, thus, the need for more personalised glycaemic control (GC).
Methods:
Retrospective data from 145 ICU patients (N=8710 hours) are used to hourly identify hourly model-based SI and
its rate of change %ΔSI in 6-hour blocks from ICU admission to 72 hours. The evolution of SI and %ΔSI are
compared for males and females. Hypothesis testing (95% confidence interval (CI) bootstrapped difference in
medians) assesses if differences are significant, and equivalence testing assesses if differences are clinically
equivalent.
Results:
Females have significantly lower SI levels than males (p<0.05), and this difference is not clinically equivalent
(Figure 1; top). Differences in %ΔSI are not significant (p>0.05), and these differences are clinically equivalent
(Figure 1; bottom).
Conclusion:
Given significantly lower SI levels, but equivalent variability, for women, equally safe and effective GC should be
achievable for both sexes. However, women may require more insulin to achieve these goals. GC protocol
designs should thus account for these differences in the future.
Disciplines :
Endocrinology, metabolism & nutrition Engineering, computing & technology: Multidisciplinary, general & others Anesthesia & intensive care
Author, co-author :
Uyttendaele, Vincent ; Université de Liège - ULiège > In silico-Model-based therapeutics, Critical Care Basic Sc.
Knopp, Jennifer L.
Shaw, Geoffrey M.
Desaive, Thomas ; Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles
Chase, J. Geoffrey
Language :
English
Title :
Higher Insulin Resistance In Female ICU Patients
Publication date :
2020
Event name :
e-ISICEM - International Symposium on Intensive Care & Emergency Medicine