A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care

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dc.contributor.authorDickson, J.L.
dc.contributor.authorAlsweiler, J.
dc.contributor.authorGunn, C.A.
dc.contributor.authorPretty, C.G.
dc.contributor.authorChase, Geoff
dc.date.accessioned2016-02-21T20:51:08Z
dc.date.available2016-02-21T20:51:08Z
dc.date.issued2016en
dc.description.abstractBackground: Model-based glycaemic control relies on sufficiency of underlying models to describe underlying patient physiology. In particular, very preterm infant glucose-insulin metabolism can differ significantly from adults, and is relatively unstudied. In this study, C-peptide concentrations are used to develop insulin-secretion models for the purposes of glycaemic control in neonatal intensive care. Methods: Plasma C-peptide, Insulin, and blood glucose concentrations (BGC) were retrospectively analyzed from a cohort of 41 hyperglycemic very preterm (median age 27.2 [26.2 - 28.7] weeks) and very low birth-weight infants (median birth weight 839 [735 – 1000] g). A 2-compartment model of C-peptide kinetics was used to estimate insulin secretion. Insulin secretion was examined with respect to nutritional intake, exogenous and plasma insulin concentration, and BGC. Results: Insulin secretion was found to be highly variable between patients and over time, and could not be modeled with respect to age, weight, or protein or dextrose intake. In 13 of 54 samples exogenous insulin was being administered, and insulin secretion was lower. However, low data numbers make this result inconclusive. Insulin secretion was found to increase with BG, with a stronger association in female infants than males (R2=0.51 vs. R2=0.13, and R2=0.26 for the combined cohort). Conclusions: A sex-based insulin secretion model was created and incorporated into a model-based glycemic control framework. Nutritional intake did not predict insulin secretion, indicating that insulin secretion is a complex function of a number of metabolic factors.en
dc.identifier.citationDickson, J.L., Alsweiler, J., Gunn, C.A., Pretty, C.G., Chase, J.G. (2016) A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care. Journal of Diabetes Science and Technology, 10(1), pp. 111-118.en
dc.identifier.doihttps://doi.org/10.1177/1932296815596175
dc.identifier.urihttp://hdl.handle.net/10092/11824
dc.language.isoen
dc.publisherUniversity of Canterbury. Mechanical Engineeringen
dc.rights.urihttps://hdl.handle.net/10092/17651
dc.subjectGlycaemic controlen
dc.subjectinsulin therapyen
dc.subjectinsulin secretionen
dc.subjectphysiological modelingen
dc.subjectvery preterm infantsen
dc.subject.anzsrcField of Research::09 - Engineering::0903 - Biomedical Engineeringen
dc.subject.anzsrcFields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320212 - Intensive careen
dc.subject.anzsrcFields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320208 - Endocrinologyen
dc.titleA C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Careen
dc.typeJournal Article
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