Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit
Introduction: Currently, there is a lack of real-time biomarker to diagnose sepsis. Insulin sensitivity (SI) may be determined in real-time using mathematical glucose-insulin models, but its effectiveness as a diagnostic test of sepsis remains unexplored. We aimed to explore the diagnostic value of...
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| Format: | Article |
| Language: | English |
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International Islamic University Malaysia
2021
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| Online Access: | http://umpir.ump.edu.my/id/eprint/32855/1/Model-based%20insulin%20sensitivity%20as%20a%20new%20biomarker%20of%20sepsis%20diagnosis.pdf |
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| author | Wan Fadzlina, Wan Muhd Shukeri Ummu Kulthum, Jamaludin Mohd Basri, Mat-Nor Azrina, Md. Ralib |
| author_facet | Wan Fadzlina, Wan Muhd Shukeri Ummu Kulthum, Jamaludin Mohd Basri, Mat-Nor Azrina, Md. Ralib |
| author_sort | Wan Fadzlina, Wan Muhd Shukeri |
| collection | UMP |
| description | Introduction: Currently, there is a lack of real-time biomarker to diagnose sepsis. Insulin sensitivity (SI) may be determined in real-time using mathematical glucose-insulin models, but its effectiveness as a diagnostic test of sepsis remains unexplored. We aimed to explore the diagnostic value of model-based SI as a new biomarker of sepsis in a mixed cohort of diabetic and non-diabetic patients newly admitted to the intensive care unit (ICU). Materials and methods: In this cross-sectional study, we analysed SI levels derived from the Intensive[1]Control-of-Insulin-Nutrition-Glucose model in septic (n=45) and non-septic (n = 41) patients upon their ICU admission. The diagnostic value of model-based SI for sepsis was determined through analysis of the area under the curve (AUC) of the receiver operating characteristic curve. Results: Baseline SI levels were significantly lower in patients with sepsis than those without sepsis (0.560 (SD=0.676) vs. 1.097 (SD=1.473) x 10-4 L/mU/min, P = 0.037). However, the AUC of 0.588 revealed that model-based SI was a poor diagnostic test of sepsis in the mixed cohort of diabetics and non-diabetics. In a separate analysis among the non-diabetics (n=19), model-based SI predicted sepsis with clinically valid performance (AUC 0.911). Conclusion: Presence of sepsis significantly reduced SI in the critically ill patients but a low SI could predict sepsis only in the non-diabetic cohort. |
| first_indexed | 2024-03-06T12:54:02Z |
| format | Article |
| id | UMPir32855 |
| institution | Universiti Malaysia Pahang |
| language | English |
| last_indexed | 2024-03-06T12:54:02Z |
| publishDate | 2021 |
| publisher | International Islamic University Malaysia |
| record_format | dspace |
| spelling | UMPir328552022-06-14T08:22:36Z http://umpir.ump.edu.my/id/eprint/32855/ Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit Wan Fadzlina, Wan Muhd Shukeri Ummu Kulthum, Jamaludin Mohd Basri, Mat-Nor Azrina, Md. Ralib RC Internal medicine RM Therapeutics. Pharmacology T Technology (General) TJ Mechanical engineering and machinery Introduction: Currently, there is a lack of real-time biomarker to diagnose sepsis. Insulin sensitivity (SI) may be determined in real-time using mathematical glucose-insulin models, but its effectiveness as a diagnostic test of sepsis remains unexplored. We aimed to explore the diagnostic value of model-based SI as a new biomarker of sepsis in a mixed cohort of diabetic and non-diabetic patients newly admitted to the intensive care unit (ICU). Materials and methods: In this cross-sectional study, we analysed SI levels derived from the Intensive[1]Control-of-Insulin-Nutrition-Glucose model in septic (n=45) and non-septic (n = 41) patients upon their ICU admission. The diagnostic value of model-based SI for sepsis was determined through analysis of the area under the curve (AUC) of the receiver operating characteristic curve. Results: Baseline SI levels were significantly lower in patients with sepsis than those without sepsis (0.560 (SD=0.676) vs. 1.097 (SD=1.473) x 10-4 L/mU/min, P = 0.037). However, the AUC of 0.588 revealed that model-based SI was a poor diagnostic test of sepsis in the mixed cohort of diabetics and non-diabetics. In a separate analysis among the non-diabetics (n=19), model-based SI predicted sepsis with clinically valid performance (AUC 0.911). Conclusion: Presence of sepsis significantly reduced SI in the critically ill patients but a low SI could predict sepsis only in the non-diabetic cohort. International Islamic University Malaysia 2021-04 Article PeerReviewed pdf en http://umpir.ump.edu.my/id/eprint/32855/1/Model-based%20insulin%20sensitivity%20as%20a%20new%20biomarker%20of%20sepsis%20diagnosis.pdf Wan Fadzlina, Wan Muhd Shukeri and Ummu Kulthum, Jamaludin and Mohd Basri, Mat-Nor and Azrina, Md. Ralib (2021) Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit. IIUM Medical Journal Malaysia, 20 (2). pp. 19-26. ISSN 2735-2285. (Published) https://doi.org/10.31436/IMJM.V20I2.1008 https://doi.org/10.31436/IMJM.V20I2.1008 |
| spellingShingle | RC Internal medicine RM Therapeutics. Pharmacology T Technology (General) TJ Mechanical engineering and machinery Wan Fadzlina, Wan Muhd Shukeri Ummu Kulthum, Jamaludin Mohd Basri, Mat-Nor Azrina, Md. Ralib Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| title | Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| title_full | Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| title_fullStr | Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| title_full_unstemmed | Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| title_short | Model-based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| title_sort | model based insulin sensitivity as a new biomarker of sepsis diagnosis in the intensive care unit |
| topic | RC Internal medicine RM Therapeutics. Pharmacology T Technology (General) TJ Mechanical engineering and machinery |
| url | http://umpir.ump.edu.my/id/eprint/32855/1/Model-based%20insulin%20sensitivity%20as%20a%20new%20biomarker%20of%20sepsis%20diagnosis.pdf |
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