Estimation of Insulin Sensitivity in Intensive Care Patients
Master thesis
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http://hdl.handle.net/11250/2616097Utgivelsesdato
2017Metadata
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Sammendrag
GlucosSet has developed a continuous intravenous sensor for blood glucose measurement with good accuracy and the ability to measure the distribution of plasma volume, something which can give new possibilities in estimating the insulin sensitivity (SI). If the SI can be identified more frequently, it could help in estimating the right amount of insulin for patients in the Intensive Care Unit (ICU), normal medical unit and diabetic patients.
This thesis takes a look at finding a faster way of estimating SI and is based on the work done in the author's project report about different glucose insulin models. In the beginning of the thesis, today's methods of estimating SI were reviewed. The Dynamic Insulin Sensitivity Test quick (DISTq) is a new and faster method that could benefit from a continuous sensor. It was explained in detail and then compared to the existing methods. In the last part of the thesis the protocol was modified to exploit the continuous GlucoSet sensor and implemented into an existing ICU patient simulator.
The results of this thesis is a modified version of the DISTq. Unfortunately, the modified version doesn't give a correct estimate of SI. The reason why is most likely the missing information about the endogenous insulin $U_{en}$ and interstitial insulin Q(t), which are important for the estimation of SI. Alas, the author of DISTq did not respond to inquiries.
The modified version of DISTq might have been a good method to estimate SI if all the information for the DISTq was available. In theory, the modified version would be more accurate and faster than the original DISTq. In practice, since too much information is missing, it is impossible to recreate the DISTq. Obviously, implies that the modified version of DISTq cannot be completed either.