The effect of Glargine as basal insulin support for recovering critically ill and high dependency unit patients: An in silico study

Jessica Lin, Normy N. Razak, Geoff Chase, Jason Wong, Chris Pretty, Jacquelyn D. Parente, A. J. LeCompte Aaron, Fatanah M. Suhaimi, Geoff Shaw, Christopher Hann

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Many critically ill patients are benefiting from extensive research done in tight glucose control (TGC) within the ICU. But moderate to high levels of hyperglycaemia are still tolerated within high dependency (HDU) and surgical units. The use and benefits of insulin protocols within these units have not yet been addressed in the literature. The management of tight glycaemic control still remains under the influence of ineffective standards characterized by tolerance for hyperglycaemia and a reluctance to use insulin intensively. A validated Glargine and intravenous insulin-glucose pharmacodynamic model are presented. Virtual trial results on 16 stable ICU patients showed that Glargine can provide effective blood glucose management for these long term recovering patients. An initial intravenous injection and higher Glargine dosing is required for the first day to quickly lower elevated blood glucose levels. However, once patient's blood glucose levels are within a desirable range, Glargine alone can provide effective glycaemic management, thus reducing nursing effort. Median blood glucose for the entire cohort when simulated with the combination of Glargine and an intravenous insulin injection is 6.5 with interquartile range of [5.6, 7.5]. The 90% confidence interval is [4.6, 9.7] with no occurrence of hypoglycaemia. This in silico study provides a first virtual trial analysis of the in-hospital transition between intravenous and subcutaneous insulin for TGC.

Original languageEnglish
Title of host publication7th IFAC Symposium on Modelling and Control in Biomedical Systems (including Biological Systems) MCBMS'09 - Proceedings
Pages49-54
Number of pages6
EditionPART 1
DOIs
Publication statusPublished - 01 Dec 2009
Event7th IFAC Symposium on Modelling and Control in Biomedical Systems (including Biological Systems) MCBMS'09 - Aalborg, Denmark
Duration: 12 Aug 200914 Aug 2009

Publication series

NameIFAC Proceedings Volumes (IFAC-PapersOnline)
NumberPART 1
Volume7
ISSN (Print)1474-6670

Other

Other7th IFAC Symposium on Modelling and Control in Biomedical Systems (including Biological Systems) MCBMS'09
CountryDenmark
CityAalborg
Period12/08/0914/08/09

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All Science Journal Classification (ASJC) codes

  • Control and Systems Engineering

Cite this

Lin, J., Razak, N. N., Chase, G., Wong, J., Pretty, C., Parente, J. D., ... Hann, C. (2009). The effect of Glargine as basal insulin support for recovering critically ill and high dependency unit patients: An in silico study. In 7th IFAC Symposium on Modelling and Control in Biomedical Systems (including Biological Systems) MCBMS'09 - Proceedings (PART 1 ed., pp. 49-54). (IFAC Proceedings Volumes (IFAC-PapersOnline); Vol. 7, No. PART 1). https://doi.org/10.3182/20090812-3-DK-2006.0075