Model-based insulin-nutrition administration for glycemic control in Malaysian critical care: First pilot trial

Abu-Samah, Asma and Ahamad, Nurhamim H. and Abdul Razak, Normy Norfiza and Suhaimi, Fatanah M. and Jamaludin, Ummu Kulthum and Md Ralib, Azrina and Mat Nor, Mohd Basri and Pretty, Christopher G. and Dickson, Jennifer L. and Chase, Geoffrey G. (2018) Model-based insulin-nutrition administration for glycemic control in Malaysian critical care: First pilot trial. In: 2nd International Conference for Innovation in Biomedical Engineering and Life Sciences, ICIBEL 2017, 10-13 December 2017, Penang; Malaysia. (In Press)

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Abstract

Stress-induced hyperglycemia is prevalent in critical care, even in patients with no history of diabetes. Control of blood glucose level with tight insulin therapy has been shown to reduce incidences of hyperglycemia leading to reduced mortality and improved clinical outcomes. STAR is a tablet-based glucose control protocol with a specialized user interface into which insulin and nutrition information can be entered and predicted. This research describes the first clinical pilot trial of STAR approach in International Islamic University Hospital, Kuantan, Malaysia. The clinically specified target for blood glucose level is between 4.4 and 8.0 mmol/L. Seven episodes (of 359 h) were recruited based on the need for glucose control. Overall, 43.93% of measurement are in the range of 4.4–8.0 mmol/L band. The blood glucose median is 8.30 [6.32–10.00] mmol/L with only 1 patient having below than 2.22 mmol/L which is the guaranteed minimum risk level. This pilot study shows that STAR protocol is a patient specific approach that provides a good glycemic control in critically ill patients. Nevertheless, its implementation in Malaysian intensive care environments requires modifications and improvements in certain areas.

Item Type:	Conference or Workshop Item (Plenary Papers)
Additional Information:	3934/64969
Uncontrolled Keywords:	Glycemic control; Model-based approach; Hyperglycemia; Critical care; Clinical trial
Subjects:	R Medicine > RM Therapeutics. Pharmacology > RM214 Diet therapy. Diet and dietectics in disease
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine
Depositing User:	Prof Azrina Md Ralib
Date Deposited:	20 Jul 2018 16:42
Last Modified:	20 Jul 2018 16:42
URI:	http://irep.iium.edu.my/id/eprint/64969

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