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

Wan Shukeri, Wan Fadzlina and Jamaludin, Ummu Kulthum and Md Ralib, Azrina and Mat Nor, Mohd Basri (2021) Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit. IIUM Medical Journal Malaysia (IMJM), 20 (2). pp. 19-26. ISSN 1823-4631 E-ISSN 2735-2285

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Abstract

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 IntensiveControl-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 (Journal)
Additional Information:	5608/89162
Uncontrolled Keywords:	: insulin sensitivity; insulin resistance; sepsis; intensive care units
Subjects:	R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
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:	Dr. Mohd Basri Mat Nor
Date Deposited:	06 Apr 2021 16:02
Last Modified:	23 Jun 2021 12:26
URI:	http://irep.iium.edu.my/id/eprint/89162

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