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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: Zafirah, R. C., Ummu Kulthum, Jamaludin, Khalijah, Khalid, Luqman, H. M., Aishah, A. F. Q. A., Azrina, R., Basri, M. N. M., Fatanah, S., Normy N., A. R.
Format: Conference or Workshop Item
Language:English
Published: IOP Publishing 2019
Subjects:
RA Public aspects of medicine
RC Internal medicine
T Technology (General)
Online Access:http://umpir.ump.edu.my/id/eprint/27326/1/Study%20on%20the%20blood%20glucose%20management%20with%20controlled.pdf
http://umpir.ump.edu.my/id/eprint/27326/
https://doi.org/10.1088/1757-899X/469/1/012097
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spelling my.ump.umpir.273262020-03-29T23:12:04Z http://umpir.ump.edu.my/id/eprint/27326/ Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients Zafirah, R. C. Ummu Kulthum, Jamaludin Khalijah, Khalid Luqman, H. M. Aishah, A. F. Q. A. Azrina, R. Basri, M. N. M. Fatanah, S. Normy N., A. R. RA Public aspects of medicine RC Internal medicine T Technology (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 tablet-computer 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 2019-01-17 Conference or Workshop Item PeerReviewed pdf en cc_by http://umpir.ump.edu.my/id/eprint/27326/1/Study%20on%20the%20blood%20glucose%20management%20with%20controlled.pdf Zafirah, R. C. and Ummu Kulthum, Jamaludin and Khalijah, Khalid and Luqman, H. M. and Aishah, A. F. Q. A. and Azrina, R. and Basri, M. N. M. and Fatanah, S. and Normy N., A. R. (2019) Study on the blood glucose management with controlled goal feed in Malaysian critically ill patients. In: IOP Conference Series: Materials Science and Engineering, 1st International Postgraduate Conference on Mechanical Engineering (IPCME2018), 31 October 2018 , UMP Library, Pekan. pp. 1-11., 469 (012097). ISSN 1757-8981 (Print), 1757-899X (Online) https://doi.org/10.1088/1757-899X/469/1/012097
institution Universiti Malaysia Pahang
building UMP Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Pahang
content_source UMP Institutional Repository
url_provider http://umpir.ump.edu.my/
language English
topic RA Public aspects of medicine
RC Internal medicine
T Technology (General)
spellingShingle RA Public aspects of medicine
RC Internal medicine
T Technology (General)
Zafirah, R. C.
Ummu Kulthum, Jamaludin
Khalijah, Khalid
Luqman, H. M.
Aishah, A. F. Q. A.
Azrina, R.
Basri, M. N. M.
Fatanah, S.
Normy N., A. R.
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 tablet-computer 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 Conference or Workshop Item
author Zafirah, R. C.
Ummu Kulthum, Jamaludin
Khalijah, Khalid
Luqman, H. M.
Aishah, A. F. Q. A.
Azrina, R.
Basri, M. N. M.
Fatanah, S.
Normy N., A. R.
author_facet Zafirah, R. C.
Ummu Kulthum, Jamaludin
Khalijah, Khalid
Luqman, H. M.
Aishah, A. F. Q. A.
Azrina, R.
Basri, M. N. M.
Fatanah, S.
Normy N., A. R.
author_sort Zafirah, R. C.
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://umpir.ump.edu.my/id/eprint/27326/1/Study%20on%20the%20blood%20glucose%20management%20with%20controlled.pdf
http://umpir.ump.edu.my/id/eprint/27326/
https://doi.org/10.1088/1757-899X/469/1/012097
_version_ 1662754765109460992
score 13.211869

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