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Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients

Stress-induced hyperglycaemia is commonly occurred in the intensive care unit (ICU). It is known that the intensive insulin therapy (IIT) has successfully managed the blood glucose level within the targeted band. However, modifications on the current practice need to be considered to minimize the ri...

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Main Authors: Rosly, Zafirah, Jamaludin, Ummu Kulthum, Khalid, Khalijah, Luqman, Humaidi, A.F.Q.A., Aishah, Md Ralib, Azrina, Mat Nor, Mohd Basri, Abdul Razak, Normy Norfiza
Format: Article
Language:English
English
English
Published: IOP Publishing 2019
Subjects:
R Medicine (General)
Online Access:http://irep.iium.edu.my/72310/1/72310_Study%20on%20the%20blood%20glucose%20management.pdf
http://irep.iium.edu.my/72310/2/72310_Study%20on%20the%20blood%20glucose%20management_SCOPUS.pdf
http://irep.iium.edu.my/72310/3/72310_Study%20on%20the%20blood%20glucose%20management_WOS.pdf
http://irep.iium.edu.my/72310/
https://iopscience.iop.org/article/10.1088/1757-899X/469/1/012097/meta
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spelling my.iium.irep.723102019-11-24T12:48:50Z http://irep.iium.edu.my/72310/ Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients Rosly, Zafirah Jamaludin, Ummu Kulthum Khalid, Khalijah Luqman, Humaidi A.F.Q.A., Aishah Md Ralib, Azrina Mat Nor, Mohd Basri Abdul Razak, Normy Norfiza R Medicine (General) Stress-induced hyperglycaemia is commonly occurred in the intensive care unit (ICU). It is known that the intensive insulin therapy (IIT) has successfully managed the blood glucose level within the targeted band. However, modifications on the current practice need to be considered to minimize the risk of hypoglycaemia and mortality. Thus, the aim of this study is to assess the performance of a new practice known as Stochastic Targeted (STAR) Protocol in managing blood glucose levels in Malaysia ICU setting. STAR is a tabletcomputer based protocols that provides patient-specific glucose control framework accounting for patient variability with a stochastically derived maximum 5% risk of hypoglycaemia events. A retrospective 92 non-diabetes patient’s data who underwent IIT were identified. Patient’s blood glucose levels, exogenous insulin and nutrition inputs including patient demographics were extracted from the ICU charts to create virtual patients by using physiologically mathematical model. Three trials were simulated with controlled goal feed (GF) and without GF. Only one type of nutrition is considered in this study which is Glucerna. The outcomes will be compared in terms of %BG within the targeted band of 4.4 to 10.0 mmol/L, the total number of BG measurements, and the % of severe hypoglycaemia. The results indicate that STAR virtual trial with controlled GF reduced the risk of hypoglycaemia to 3% and the clinical burden up to 1630 hours while maintaining BG within the targeted band. The total number of BG measurements also decreased to 5384 from 7038. Thus, the implementation of STAR protocol in the Malaysia ICU is beneficial and it is proven safe while aiding nurses and physicians in reducing the clinical burden and medical cost in treating stress-induce hyperglycaemia in the demanding ICU setting. IOP Publishing 2019 Article PeerReviewed application/pdf en http://irep.iium.edu.my/72310/1/72310_Study%20on%20the%20blood%20glucose%20management.pdf application/pdf en http://irep.iium.edu.my/72310/2/72310_Study%20on%20the%20blood%20glucose%20management_SCOPUS.pdf application/pdf en http://irep.iium.edu.my/72310/3/72310_Study%20on%20the%20blood%20glucose%20management_WOS.pdf Rosly, Zafirah and Jamaludin, Ummu Kulthum and Khalid, Khalijah and Luqman, Humaidi and A.F.Q.A., Aishah and Md Ralib, Azrina and Mat Nor, Mohd Basri and Abdul Razak, Normy Norfiza (2019) Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients. IOP Conference Series: Materials Science and Engineering, 469 (2019). pp. 1-10. ISSN 1757-8981 https://iopscience.iop.org/article/10.1088/1757-899X/469/1/012097/meta 10.1088/1757-899X/469/1/012097
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
English
topic R Medicine (General)
spellingShingle R Medicine (General)
Rosly, Zafirah
Jamaludin, Ummu Kulthum
Khalid, Khalijah
Luqman, Humaidi
A.F.Q.A., Aishah
Md Ralib, Azrina
Mat Nor, Mohd Basri
Abdul Razak, Normy Norfiza
Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients
description Stress-induced hyperglycaemia is commonly occurred in the intensive care unit (ICU). It is known that the intensive insulin therapy (IIT) has successfully managed the blood glucose level within the targeted band. However, modifications on the current practice need to be considered to minimize the risk of hypoglycaemia and mortality. Thus, the aim of this study is to assess the performance of a new practice known as Stochastic Targeted (STAR) Protocol in managing blood glucose levels in Malaysia ICU setting. STAR is a tabletcomputer based protocols that provides patient-specific glucose control framework accounting for patient variability with a stochastically derived maximum 5% risk of hypoglycaemia events. A retrospective 92 non-diabetes patient’s data who underwent IIT were identified. Patient’s blood glucose levels, exogenous insulin and nutrition inputs including patient demographics were extracted from the ICU charts to create virtual patients by using physiologically mathematical model. Three trials were simulated with controlled goal feed (GF) and without GF. Only one type of nutrition is considered in this study which is Glucerna. The outcomes will be compared in terms of %BG within the targeted band of 4.4 to 10.0 mmol/L, the total number of BG measurements, and the % of severe hypoglycaemia. The results indicate that STAR virtual trial with controlled GF reduced the risk of hypoglycaemia to 3% and the clinical burden up to 1630 hours while maintaining BG within the targeted band. The total number of BG measurements also decreased to 5384 from 7038. Thus, the implementation of STAR protocol in the Malaysia ICU is beneficial and it is proven safe while aiding nurses and physicians in reducing the clinical burden and medical cost in treating stress-induce hyperglycaemia in the demanding ICU setting.
format Article
author Rosly, Zafirah
Jamaludin, Ummu Kulthum
Khalid, Khalijah
Luqman, Humaidi
A.F.Q.A., Aishah
Md Ralib, Azrina
Mat Nor, Mohd Basri
Abdul Razak, Normy Norfiza
author_facet Rosly, Zafirah
Jamaludin, Ummu Kulthum
Khalid, Khalijah
Luqman, Humaidi
A.F.Q.A., Aishah
Md Ralib, Azrina
Mat Nor, Mohd Basri
Abdul Razak, Normy Norfiza
author_sort Rosly, Zafirah
title Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients
title_short Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients
title_full Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients
title_fullStr Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients
title_full_unstemmed Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients
title_sort study on the blood glucose management with controlled goal feed in malaysian critically ill patients
publisher IOP Publishing
publishDate 2019
url http://irep.iium.edu.my/72310/1/72310_Study%20on%20the%20blood%20glucose%20management.pdf
http://irep.iium.edu.my/72310/2/72310_Study%20on%20the%20blood%20glucose%20management_SCOPUS.pdf
http://irep.iium.edu.my/72310/3/72310_Study%20on%20the%20blood%20glucose%20management_WOS.pdf
http://irep.iium.edu.my/72310/
https://iopscience.iop.org/article/10.1088/1757-899X/469/1/012097/meta
_version_ 1651865916051292160
score 13.211869

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