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

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 i...

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Main Authors: Abu-Samah, Asma, Abdul Razak, Normy Norfiza, Jamaludin, Ummu Kulthum, Mohamad Suhaimi, Fatanah, Md Ralib, Azrina
Format: Article
Language:English
English
Published: Institute of Advanced Engineering and Science 2019
Subjects:
Online Access:http://irep.iium.edu.my/79818/
http://irep.iium.edu.my/79818/1/79818_Determination%20of%20favorable%20blood%20glucose%20target%20range%20_article.pdf
http://irep.iium.edu.my/79818/2/79818_Determination%20of%20favorable%20blood%20glucose%20target%20range%20_scopus.pdf
_version_ 1848788850685509632
author Abu-Samah, Asma
Abdul Razak, Normy Norfiza
Jamaludin, Ummu Kulthum
Mohamad Suhaimi, Fatanah
Md Ralib, Azrina
author_facet Abu-Samah, Asma
Abdul Razak, Normy Norfiza
Jamaludin, Ummu Kulthum
Mohamad Suhaimi, Fatanah
Md Ralib, Azrina
author_sort Abu-Samah, Asma
building IIUM Repository
collection Online Access
description 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.
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spelling iium-798182020-06-25T04:21:58Z http://irep.iium.edu.my/79818/ Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia Abu-Samah, Asma Abdul Razak, Normy Norfiza Jamaludin, Ummu Kulthum Mohamad Suhaimi, Fatanah Md Ralib, Azrina R Medicine (General) 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. Institute of Advanced Engineering and Science 2019-07 Article PeerReviewed application/pdf en http://irep.iium.edu.my/79818/1/79818_Determination%20of%20favorable%20blood%20glucose%20target%20range%20_article.pdf application/pdf en http://irep.iium.edu.my/79818/2/79818_Determination%20of%20favorable%20blood%20glucose%20target%20range%20_scopus.pdf 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 http://ijeecs.iaescore.com/index.php/IJEECS/article/view/18484/12544 10.11591/ijeecs.v15.i1.pp133-141
spellingShingle R Medicine (General)
Abu-Samah, Asma
Abdul Razak, Normy Norfiza
Jamaludin, Ummu Kulthum
Mohamad Suhaimi, Fatanah
Md Ralib, Azrina
Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia
title Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia
title_full Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia
title_fullStr Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia
title_full_unstemmed Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia
title_short Determination of favorable blood glucose target range for stochastic TARgeted (STAR) glycemic control in Malaysia
title_sort determination of favorable blood glucose target range for stochastic targeted (star) glycemic control in malaysia
topic R Medicine (General)
url http://irep.iium.edu.my/79818/
http://irep.iium.edu.my/79818/
http://irep.iium.edu.my/79818/
http://irep.iium.edu.my/79818/1/79818_Determination%20of%20favorable%20blood%20glucose%20target%20range%20_article.pdf
http://irep.iium.edu.my/79818/2/79818_Determination%20of%20favorable%20blood%20glucose%20target%20range%20_scopus.pdf