Simulation and qualitative analysis of glucose variability, mean glucose, and hypoglycemia after subcutaneous insulin therapy for stress hyperglycemia

Theoretical Biology & Medical Modelling
Richard J StrilkaScott B Armen

Abstract

The critically ill can have persistent dysglycemia during the "subacute" recovery phase of their illness because of altered gene expression; it is also not uncommon for these patients to receive continuous enteral nutrition during this time. The optimal short-acting subcutaneous insulin therapy that should be used in this clinical scenario, however, is unknown. Our aim was to conduct a qualitative numerical study of the glucose-insulin dynamics within this patient population to answer the above question. This analysis may help clinicians design a relevant clinical trial. Eight virtual patients with stress hyperglycemia were simulated by means of a mathematical model. Each virtual patient had a different combination of insulin resistance and insulin deficiency that defined their unique stress hyperglycemia state; the rate of gluconeogenesis was also doubled. The patients received 25 injections of subcutaneous regular or Lispro insulin (0-6 U) with 3 rates of continuous nutrition. The main outcome measurements were the change in mean glucose concentration, the change in glucose variability, and hypoglycemic episodes. These end points were interpreted by how the ultradian oscillations of glucose concentration were affected by each...Continue Reading

References

May 1, 1990·The Journal of Trauma·M JeevanandamW R Schiller
Oct 1, 1982·Annals of Surgery·P R BlackD W Wilmore
Jan 1, 1994·The British Journal of Surgery·A ThorellO Ljungqvist
May 1, 1996·Metabolism: Clinical and Experimental·T FujiwaraO P McGuinness
Nov 14, 1997·Diabetes Care·B P KovatchevW Clarke
Apr 21, 1999·Clinical Science·R C Andrews, B R Walker
Oct 3, 2000·Journal of Theoretical Biology·B ToppD T Finegood
Nov 18, 2000·Journal of Theoretical Biology·I M TolićJ Sturis
Jan 14, 2005·The New England Journal of Medicine·Irl B Hirsch
Apr 29, 2005·Diabetes Technology & Therapeutics·C M McDonnellF J Cameron
May 4, 2005·Journal of Diabetes and Its Complications·Irl B Hirsch, Michael Brownlee
Oct 8, 2005·American Heart Journal·Masaharu IshiharaUNKNOWN Japanese Acute Coronary Syndrome Study Investigators
Apr 13, 2006·JAMA : the Journal of the American Medical Association·Louis MonnierClaude Colette
Jul 6, 2007·Mathematical Biosciences·Haiyan WangYang Kuang
Apr 17, 2008·Critical Care : the Official Journal of the Critical Care Forum·J Geoffrey ChaseChristopher Hann
Jul 4, 2008·Critical Care Medicine·Naeem A AliJean-Charles Preiser
Aug 14, 2008·The Journal of Clinical Endocrinology and Metabolism·Deborah J WexlerEnrico Cagliero
Aug 19, 2008·The American Surgeon·Lesly A DossettAddison K May
Jan 10, 2009·The Journal of Trauma·Nathan T MoweryAddison K May
Mar 26, 2009·The New England Journal of Medicine·Simon FinferJuan J Ronco
Apr 16, 2009·JAMA : the Journal of the American Medical Association·Mikhail KosiborodJohn A Spertus
Jul 17, 2009·Computer Methods and Programs in Biomedicine·Cheng-Liang Chen, Hong-Wen Tsai
Nov 3, 2009·Surgical Infections·Nathan T MoweryAddison K May
Nov 21, 2009·Journal of Critical Care·Ulrike PielmeierPernille Haure
Dec 8, 2009·Endocrine Reviews·Sarah E SiegelaarJ Hans DeVries
Dec 26, 2009·Critical Care Medicine·Jeroen HermanidesJ Hans Devries
Feb 11, 2010·Journal of Diabetes Science and Technology·James Stephen Krinsley
Mar 24, 2010·Journal of Diabetes Science and Technology·Fatanah SuhaimiJ Geoffrey Chase
May 29, 2010·Diabetes Care·Cyrus V DesouzaVivian Fonseca
Aug 3, 2010·Diabetes Research and Clinical Practice·M E ErtorerN G Demirag
Feb 1, 2011·Intensive Care Medicine·Saeid EslamiAmeen Abu-Hanna
Jan 1, 2009·Journal of Biological Dynamics·Haiyan WangYang Kuang
Sep 3, 2011·Journal of Emergencies, Trauma, and Shock·Evert A ErikssonMickey M Ott
Dec 30, 2011·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Elisa HsiaBoris Draznin

❮ Previous
Next ❯

Citations

May 30, 2019·Theoretical Biology & Medical Modelling·Pedro José Gutiérrez-DiezJose Russo
Jul 8, 2016·Endocrine·Heung Yong JinTae Sun Park

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.