A simulation model of insulin saturation and glucose balance for glycemic control in ICU patients
| Autor: | Birgitte Steenfeldt Nielsen, Pernille Haure, J. Geoffrey Chase, Ulrike Pielmeier, Steen Andreassen |
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| Rok vydání: | 2008 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Icu patients medicine.medical_treatment Blood sugar Health Informatics Models Biological Physiological model Intensive care Internal medicine Glucose control medicine Humans Insulin Intensive care medicine Blood Glucose Measurement Glycemic business.industry Insulin sensitivity Computer Science Applications Critical care Intensive Care Units Hyperglycemia Cardiology Saturation (chemistry) business Software |
| Zdroj: | Pielmeier, U, Andreassen, S, Nielsen, B S, Chase, J G & Haure, P 2010, ' A simulation model of insulin saturation and glucose balance for glycemic control in ICU patients ', Computer Methods and Programs in Biomedicine, vol. 97, no. 3, pp. 211-22 . https://doi.org/10.1016/j.cmpb.2009.06.004 Pielmeier, U, Andreassen, S, Nielsen, B S, Chase, J G & Christensen, P H 2010, ' A simulation model of insulin saturation and glucose balance for glycemic control in ICU patients ', Computer Methods and Programs in Biomedicine, vol. 97, no. 3, pp. 211-222 . https://doi.org/10.1016/j.cmpb.2009.06.004 |
| ISSN: | 1872-7565 |
| DOI: | 10.1016/j.cmpb.2009.06.004 |
| Popis: | Consistent tight blood sugar control in critically ill patients has proven elusive. Properly accounting for the saturation of insulin action and reducing the need for frequent measurements are important aspects in intensive insulin therapy. This paper presents a composite metabolic model, 'Glucosafe', that integrates models and parameters from normal physiology and accounts for the reduced rate of glucose gut absorption and saturation of insulin action in patients with reduced insulin sensitivity. Particularly, two different sites of reduced insulin sensitivity, before and after the non-linearity of insulin action, are explored with this model. These approaches are assessed based on the model's accuracy in retrospectively predicting blood glucose measurements of 10 randomly chosen, hyperglycemic intensive care patients. For each patient, median absolute percent error is25% for prediction timesor = 270min and modelling reduced insulin sensitivity after the non-linearity, compared to29% for modelling reduced insulin sensitivity before the non-linearity. Scaling the insulin effect (after the non-linearity) is a suitable assumption in this model structure. These results are preliminary and subject to further and more extensive validation of the model's capability to predict the longer term (2h) blood glucose excursion in critically ill patients. |
| Databáze: | OpenAIRE |
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