14th IFAC Symposium on System Identification, SYSID 2006

SYSID-2006 Paper Abstract

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Paper WeB4.2

Wink, Freke (Univ. of Cambridge), Wilinska, Malgorzata E (Univ. of Cambridge), Chassin, Ludovic J (Univ. of Cambridge), Haluzik, Martin (3rd Internal Clinic), Blaha, Jan (3rd Internal Clinic), Svacina, Stepan (3rd Internal Clinic), Hovorka, Roman (Univ. of Cambridge)

Time-Variant Insulin Sensitivity in Critically Ill Subjects

Scheduled for presentation during the Invited Session "Biomedical Parameter Identification: Methods and Clinical Applications" (WeB4), Wednesday, March 29, 2006, 15:50−16:10, Cummings Room

14th IFAC Symposium on System Identification, March 29 - 31, 2006, Newcastle, Australia

This information is tentative and subject to change. Compiled on July 17, 2018

Keywords Nonlinear System Identification, Grey Box Modelling, Biological Systems

Abstract

Critically ill subjects display high temporal variations in insulin sensitivity, which complicate efficient glucose control by glucose controllers. In the present study, we combined a simple, discrete-time model of glucoregulation with the regularisation method to obtain a time-variant marker of insulin sensitivity from hourly plasma glucose measurements and information about intravenous insulin infusion and parenteral intake in six critically ill subjects studied over 24 to 48h. The focus of the study was to determine “basal insulin requirements” representing insulin appearance, which maintains normoglycaemia. We observed up to five-fold variations in the basal insulin requirements over a period of 8-10h in a half of the studied subjects. The remaining subjects had virtually unchanged basal insulin requirements. We conclude that considerable heterogeneity exist in the temporal variation of insulin resistance in critically ill subjects.