Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia

Asma Abu-Samah, Normy Norfiza Abdul Razak, Ummu Kulthum Jamaludin, Fatanah Mohamad Suhaimi, Azrina Mad Ralib

Research output: Contribution to journalArticle

Abstract

Stress-induced hyperglycemia is common in critically ill patients, but there is uncertainty about what constitutes an optimal blood glucose target range for glycemic control. Furthermore, to reduce the rate of hyperglycemic and hypoglycemic events, model-based glycemic control protocols have been introduced, such as the stochastic targeted (STAR) glycemic control protocol. This protocol has been used in the intensive care units of Christchurch and Gyulà Hospital since 2010, and in Malaysia since 2017. In this study, we analyzed the adaptability of the protocol and identified the blood glucose target range most favorable for use in the Malaysian population. Virtual simulation results are presented for two clinical cohorts: one receiving treatment by the STAR protocol itself and the other receiving intensive insulin therapy by the sliding scale method. Performance and safety were analyzed using five clinical target ranges, and best control was simulated at a target range of 6.0–10.0 mmol/L. This target range had the best balance of performance, with the lowest risk of hypoglycemia and the lowest requirement for nursing interventions. The result is encouraging as the STAR protocol is suitable to provide better and safer glycemic control while using a target range that is already widely used in Malaysian intensive care units.

Original languageEnglish
Pages (from-to)133-141
Number of pages9
JournalIndonesian Journal of Electrical Engineering and Computer Science
Volume15
Issue number1
DOIs
Publication statusPublished - 01 Jul 2019

Fingerprint

Malaysia
Glucose
Blood
Target
Intensive care units
Range of data
Lowest
Nursing
Insulin
Model-based Control
Unit
Adaptability
Therapy
Safety
Uncertainty
Requirements
Simulation

All Science Journal Classification (ASJC) codes

  • Signal Processing
  • Information Systems
  • Hardware and Architecture
  • Computer Networks and Communications
  • Control and Optimization
  • Electrical and Electronic Engineering

Cite this

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abstract = "Stress-induced hyperglycemia is common in critically ill patients, but there is uncertainty about what constitutes an optimal blood glucose target range for glycemic control. Furthermore, to reduce the rate of hyperglycemic and hypoglycemic events, model-based glycemic control protocols have been introduced, such as the stochastic targeted (STAR) glycemic control protocol. This protocol has been used in the intensive care units of Christchurch and Gyul{\`a} Hospital since 2010, and in Malaysia since 2017. In this study, we analyzed the adaptability of the protocol and identified the blood glucose target range most favorable for use in the Malaysian population. Virtual simulation results are presented for two clinical cohorts: one receiving treatment by the STAR protocol itself and the other receiving intensive insulin therapy by the sliding scale method. Performance and safety were analyzed using five clinical target ranges, and best control was simulated at a target range of 6.0–10.0 mmol/L. This target range had the best balance of performance, with the lowest risk of hypoglycemia and the lowest requirement for nursing interventions. The result is encouraging as the STAR protocol is suitable to provide better and safer glycemic control while using a target range that is already widely used in Malaysian intensive care units.",
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Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia. / Abu-Samah, Asma; Abdul Razak, Normy Norfiza; Jamaludin, Ummu Kulthum; Suhaimi, Fatanah Mohamad; Ralib, Azrina Mad.

In: Indonesian Journal of Electrical Engineering and Computer Science, Vol. 15, No. 1, 01.07.2019, p. 133-141.

Research output: Contribution to journalArticle

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