Model-based insulin-nutrition administration for glycemic control in Malaysian critical care: First pilot trial

Type of content
Journal Article
Thesis discipline
Degree name
Publisher
Journal Title
Journal ISSN
Volume Title
Language
Date
2018
Authors
Abu-Samah A
Ahamad NH
Razak NN
Suhaimi FM
Jamaluddin UK
Ralib AM
Mat-Nor MB
Pretty CG
Dickson JL
Chase, Geoff
Abstract

© 2018, Springer Science+Business Media Singapore. Stress-induced hyperglycemia is prevalent in critical care, even in patients with no history of diabetes. Control of blood glucose level with tight insulin therapy has been shown to reduce incidences of hyperglycemia leading to reduced mortality and improved clinical outcomes. STAR is a tablet-based glucose control protocol with a specialized user interface into which insulin and nutrition information can be entered and predicted. This research describes the first clinical pilot trial of STAR approach in International Islamic University Hospital, Kuantan, Malaysia. The clinically specified target for blood glucose level is between 4.4 and 8.0 mmol/L. Seven episodes (of 359 h) were recruited based on the need for glucose control. Overall, 43.93% of measurement are in the range of 4.4–8.0 mmol/L band. The blood glucose median is 8.30 [6.32–10.00] mmol/L with only 1 patient having below than 2.22 mmol/L which is the guaranteed minimum risk level. This pilot study shows that STAR protocol is a patient specific approach that provides a good glycemic control in critically ill patients. Nevertheless, its implementation in Malaysian intensive care environments requires modifications and improvements in certain areas.

Description
Citation
Keywords
glycemic control, model-based approach, hyperglycemia, critical care, clinical trial
Ngā upoko tukutuku/Māori subject headings
ANZSRC fields of research
Fields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320208 - Endocrinology
Fields of Research::40 - Engineering::4003 - Biomedical engineering::400305 - Biomedical instrumentation
Rights