Insulin kinetics during hyper-insulinemia euglycemia therapy (HIET) (2012)
Type of ContentConference Contributions - Published
PublisherUniversity of Canterbury. Mechanical Engineering
AuthorsPenning, S., Massion, P., Le Compte, A.J., Desaive, T., Chase, J.G.show all
High insulin euglycemia therapy (HIET) is a supra-physiological insulin dosing protocol used in acute cardiac failure to reduce dependency on inotropes to augment or generate cardiac output, and is based on the inotropic effects of insulin at high doses up to 45-250x normal daily dose. Such high insulin doses are managed using intravenous glucose infusion to control glycemia and prevent hypoglycemia. However, both insulin dosing and glycemic control in these patients is managed ad-hoc. This research examines a selection of clinical data to determine the effect of high insulin dosing on renal clearance and insulin sensitivity, to assess the feasibility of using model-based methods to control and guide these protocols. The results show that the model and, in particular, the modeled renal clearance constant are adequate and capture measured data well, although not perfectly. Equally, insulin sensitivity over time is similar to broader critical care cohorts in level and variability, and these results are the first time they have been presented for this cohort. While more data is needed to confirm and further specify these results, it is clear that the model used is adequate for controlling HIET in a model-based framework.
CitationPenning, S., Massion, P., Le Compte, A.J., Desaive, T., Chase, J.G. (2012) Insulin kinetics during hyper-insulinemia euglycemia therapy (HIET). Budapest, Hungary: 8th IFAC Symposium on Biological and Medical Systems (BMS12), 29-31 Aug 2012. Biological and Medical Systems, 8, 1, 295-300.
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Keywordsrenal clearance; HIET; cardiac failure; critically ill; model-based control; insulin sensitivity
ANZSRC Fields of Research11 - Medical and Health Sciences::1102 - Cardiovascular Medicine and Haematology::110202 - Haematology
11 - Medical and Health Sciences::1103 - Clinical Sciences::110306 - Endocrinology
11 - Medical and Health Sciences::1103 - Clinical Sciences::110310 - Intensive Care
11 - Medical and Health Sciences::1103 - Clinical Sciences::110312 - Nephrology and Urology
09 - Engineering::0903 - Biomedical Engineering