Model-based glycaemic control in multicentre icus within diabetic patients: In-silico analysis

Athirah, Abdul Razak and Normy Norfiza, Abdul Razak and Norliyana, Nor Hisham Shah and Asma, Abu-Samah and Ummu Kulthum, Jamaludin and Fatanah, Mohamad Suhaimi (2024) Model-based glycaemic control in multicentre icus within diabetic patients: In-silico analysis. International Journal of Integrated Engineering, 16 (3). pp. 67-77. ISSN 2229-838X. (Published)

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Abstract

Sliding-scale insulin therapy has been vastly used for glycaemic control but dysglycaemia remains high. Model-based glycaemic control that incorporates insulin nutrition protocol was proposed as this therapy provides personalized care to avoid dysglycaemia. Thus, this paper aims to implement in-silico simulation and identify which model-based control protocols yield better protocol within ICU diabetic patients based on performance and safety. Multicentre ICU patients of 282 were divided into diabetes mellitus (DM) and non-diabetes mellitus (NDM) cohort where in-silico simulations were done using Specialised Relative Insulin Nutrition Therapy (SPRINT), SPRINT+Glargine and Stochastic Targeted (STAR) protocols. Performance was verified based on the percentage of blood glucose (BG) time in band (TIB) 6.0 – 10.0 mmol/L and safety with number of mild and severe hypoglycaemia episodes. Among the three protocols, STAR protocol showed the highest median and interquartile range % BG TIB 6.0 – 10.0 mmol/L for DM and NDM patients with 71.6 % [57.9 – 79.8] and 77.4 % [62.9 – 88.8]. The number of hypoglycaemia episodes are the lowest in DM and NDM patients too compared to other protocols. These advantages show that STAR protocol can provide better patient outcomes for glycaemic control with personalized care.

Item Type: Article
Additional Information: Indexed by Scopus
Uncontrolled Keywords: Diabetes; Glycaemic control; Insulin therapy; Model-based protocol; Virtual trial
Subjects: T Technology > T Technology (General)
T Technology > TA Engineering (General). Civil engineering (General)
T Technology > TJ Mechanical engineering and machinery
T Technology > TL Motor vehicles. Aeronautics. Astronautics
Faculty/Division: College of Engineering
Faculty of Mechanical and Automotive Engineering Technology
Depositing User: Mr Muhamad Firdaus Janih@Jaini
Date Deposited: 21 Jan 2025 08:43
Last Modified: 21 Jan 2025 08:43
URI: http://umpir.ump.edu.my/id/eprint/43644
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