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

Abu-Samah, Asma and Abdul Razak, Normy Norfiza and Jamaludin, Ummu Kulthum and Mohamad Suhaimi, Fatanah and Md Ralib, Azrina (2019) Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia. Indonesian Journal of Electrical Engineering and Computer Science, 15 (1). pp. 133-141. ISSN 2502-4752

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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 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.

Item Type: Article (Journal)
Additional Information: 3934/79818
Uncontrolled Keywords: Blood glucose target range, Feedback control, Glycemic control, Intensive care units, Malaysian patients
Subjects: R Medicine > R Medicine (General)
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine
Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User: Assoc Prof Azrina Md Ralib
Date Deposited: 20 Apr 2020 14:24
Last Modified: 25 Jun 2020 12:21
URI: http://irep.iium.edu.my/id/eprint/79818

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