Wilinska Malgorzata E, Nodale Marianna
University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom.
J Diabetes Sci Technol. 2009 Jul 1;3(4):857-62. doi: 10.1177/193229680900300433.
The objective of this study was to investigate the performance of a newly proposed insulin titrating algorithm to achieve tight glycemic control in the critically ill.
A simulation environment with 10 critically ill virtual subjects was employed to evaluate the "I, Pancreas" algorithm proposed by Braithwaite et al. and described in an article in this issue of Journal of Diabetes Science and Technology. The algorithm was coded in MATLAB and was "plugged in" to a simulation environment to provide glucose control in a 48-hour-long simulated study.
Mean blood glucose was 6.5 +/- 0.4 mmol/liter (118 +/- 7.8 mg/dl), percentage of time spent in the target glucose range was 38% (32-44%), and the hyperglycemic index was 0.6 (0.4 -1.0) mmol/liter [11.1 (7.7-18.1) mg/dl]. A single episode of mild hypoglycemia at 3.8 mmol/liter (69 mg/dl) was observed during 480 hours of glucose control.
In this initial in silico evaluation, the "I, Pancreas" algorithm provided a safe control of glucose in the simulated study and achieved tight glycemic control 38% of the time.
本研究的目的是调查一种新提出的胰岛素滴定算法在危重症患者中实现严格血糖控制的效果。
采用具有10名危重症虚拟受试者的模拟环境，以评估Braithwaite等人提出并在本期《糖尿病科学与技术杂志》一篇文章中描述的“I，胰腺”算法。该算法用MATLAB编码，并“插入”到模拟环境中，以便在长达48小时的模拟研究中提供血糖控制。
平均血糖为6.5±0.4毫摩尔/升（118±7.8毫克/分升），处于目标血糖范围内的时间百分比为38%（32 - 44%），高血糖指数为0.6（0.4 - 1.0）毫摩尔/升[11.1（7.7 - 18.1）毫克/分升]。在480小时的血糖控制期间，观察到一次3.8毫摩尔/升（69毫克/分升）的轻度低血糖事件。
在本次初步的计算机模拟评估中，“I，胰腺”算法在模拟研究中提供了安全的血糖控制，且38%的时间实现了严格的血糖控制。
