Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit

Wan Fadzlina, Wan Muhd Shukeri and Ummu Kulthum, Jamaludin and Mohd Basri, Mat-Nor and Azrina, Md. Ralib (2021) Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit. IIUM Medical Journal Malaysia, 20 (2). pp. 19-26. ISSN 2735-2285. (Published)

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Introduction: Currently, there is a lack of real-time biomarker to diagnose sepsis. Insulin sensitivity (SI) may be determined in real-time using mathematical glucose-insulin models, but its effectiveness as a diagnostic test of sepsis remains unexplored. We aimed to explore the diagnostic value of model-based SI as a new biomarker of sepsis in a mixed cohort of diabetic and non-diabetic patients newly admitted to the intensive care unit (ICU). Materials and methods: In this cross-sectional study, we analysed SI levels derived from the Intensive[1]Control-of-Insulin-Nutrition-Glucose model in septic (n=45) and non-septic (n = 41) patients upon their ICU admission. The diagnostic value of model-based SI for sepsis was determined through analysis of the area under the curve (AUC) of the receiver operating characteristic curve. Results: Baseline SI levels were significantly lower in patients with sepsis than those without sepsis (0.560 (SD=0.676) vs. 1.097 (SD=1.473) x 10-4 L/mU/min, P = 0.037). However, the AUC of 0.588 revealed that model-based SI was a poor diagnostic test of sepsis in the mixed cohort of diabetics and non-diabetics. In a separate analysis among the non-diabetics (n=19), model-based SI predicted sepsis with clinically valid performance (AUC 0.911). Conclusion: Presence of sepsis significantly reduced SI in the critically ill patients but a low SI could predict sepsis only in the non-diabetic cohort.

Item Type: Article
Additional Information: Indexed by Scopus
Uncontrolled Keywords: Insulin resistance; Insulin sensitivity; Intensive care units; Sepsis
Subjects: R Medicine > RC Internal medicine
R Medicine > RM Therapeutics. Pharmacology
T Technology > T Technology (General)
T Technology > TJ Mechanical engineering and machinery
Faculty/Division: Faculty of Mechanical and Automotive Engineering Technology
Depositing User: Mr Muhamad Firdaus Janih@Jaini
Date Deposited: 14 Jun 2022 08:22
Last Modified: 14 Jun 2022 08:22
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