Performance of Stochastic Targeted Blood Glucose Control Protocol by virtual trials in the Malaysian intensive care unit

Jamaludin UK 1 , M Suhaimi F 2 , Abdul Razak NN 3 , Md Ralib A 4 , Mat Nor MB 4 , Pretty CG 5 Show all authors , Humaidi L 6

Affiliations 

  • 1 Universiti Malaysia Pahang, Faculty of Mechanical Engineering, 26600 Pekan, Pahang, Malaysia. Electronic address: ummu85@ump.edu.my
  • 2 Universiti Sains Malaysia, Advanced Medical and Dental Institute, 13200 Bertam, Kepala Batas, Penang, Malaysia
  • 3 Universiti Tenaga Nasional, College of Engineering, Putrajaya Campus, 43000 Kajang, Selangor, Malaysia
  • 4 International Islamic University Malaysia, Kuliyyah of Medicine, 25200 Kuantan, Pahang, Malaysia
  • 5 University of Canterbury, Department of Mechanical Engineering, Private Bag 4800, Christchurch 8041, New Zealand
  • 6 Universiti Malaysia Pahang, Faculty of Mechanical Engineering, 26600 Pekan, Pahang, Malaysia
Comput Methods Programs Biomed, 2018 Aug;162:149-155.
PMID: 29903481 DOI: 10.1016/j.cmpb.2018.03.001

Abstract

BACKGROUND AND OBJECTIVE: Blood glucose variability is common in healthcare and it is not related or influenced by diabetes mellitus. To minimise the risk of high blood glucose in critically ill patients, Stochastic Targeted Blood Glucose Control Protocol is used in intensive care unit at hospitals worldwide. Thus, this study focuses on the performance of stochastic modelling protocol in comparison to the current blood glucose management protocols in the Malaysian intensive care unit. Also, this study is to assess the effectiveness of Stochastic Targeted Blood Glucose Control Protocol when it is applied to a cohort of diabetic patients.

METHODS: Retrospective data from 210 patients were obtained from a general hospital in Malaysia from May 2014 until June 2015, where 123 patients were having comorbid diabetes mellitus. The comparison of blood glucose control protocol performance between both protocol simulations was conducted through blood glucose fitted with physiological modelling on top of virtual trial simulations, mean calculation of simulation error and several graphical comparisons using stochastic modelling.

RESULTS: Stochastic Targeted Blood Glucose Control Protocol reduces hyperglycaemia by 16% in diabetic and 9% in nondiabetic cohorts. The protocol helps to control blood glucose level in the targeted range of 4.0-10.0 mmol/L for 71.8% in diabetic and 82.7% in nondiabetic cohorts, besides minimising the treatment hour up to 71 h for 123 diabetic patients and 39 h for 87 nondiabetic patients.

CONCLUSION: It is concluded that Stochastic Targeted Blood Glucose Control Protocol is good in reducing hyperglycaemia as compared to the current blood glucose management protocol in the Malaysian intensive care unit. Hence, the current Malaysian intensive care unit protocols need to be modified to enhance their performance, especially in the integration of insulin and nutrition intervention in decreasing the hyperglycaemia incidences. Improvement in Stochastic Targeted Blood Glucose Control Protocol in terms of uen model is also a must to adapt with the diabetic cohort.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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