Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study
antibiotic agent; corticosteroid; glucose; hypertensive factor; infusion fluid; inotropic agent; insulin; adult; Article; artificial ventilation; clinical article; cohort analysis; controlled study; diagnostic value; female; glucose blood level; hospital admission; human; inotropism; insulin depende...
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my.uniten.dspace-238062023-05-29T14:51:58Z Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study Shukeri W.F.W.M. Mat-Nor M.B. Jamaludin U.K. Suhaimi F. Razak N.N.A. Ralib A.M. 57189369133 57226799207 55330889600 36247893200 37059587300 37031770900 antibiotic agent; corticosteroid; glucose; hypertensive factor; infusion fluid; inotropic agent; insulin; adult; Article; artificial ventilation; clinical article; cohort analysis; controlled study; diagnostic value; female; glucose blood level; hospital admission; human; inotropism; insulin dependent diabetes mellitus; insulin infusion; insulin sensitivity; intensive care unit; male; middle aged; non insulin dependent diabetes mellitus; predictive value; receiver operating characteristic; renal replacement therapy; retrospective study; sensitivity and specificity; sepsis Background and Aims: Currently, there is a lack of real-time metric with high sensitivity and specificity to diagnose sepsis. Insulin sensitivity (SI) may be determined in real-time using mathematical glucose-insulin models; however, its effectiveness as a diagnostic test of sepsis is unknown. Our aims were to determine the levels and diagnostic value of model-based SI for identification of sepsis in critically ill patients. Materials and Methods: In this retrospective, cohort study, we analyzed SI levels in septic (n = 18) and nonseptic (n = 20) patients at 1 (baseline), 4, 8, 12, 16, 20, and 24 h of their Intensive Care Unit admission. Patients with diabetes mellitus Type I or Type II were excluded from the study. The SI levels were derived by fitting the blood glucose levels, insulin infusion and glucose input rates into the Intensive Control of Insulin-Nutrition-Glucose model. Results: The median SI levels were significantly lower in the sepsis than in the nonsepsis at all follow-up time points. The areas under the receiver operating characteristic curve of the model-based SI at baseline for discriminating sepsis from nonsepsis was 0.814 (95% confidence interval, 0.675-0.953). The optimal cutoff point of the SI test was 1.573 � 10-4 L/mu/min. At this cutoff point, the sensitivity was 77.8%, specificity was 75%, positive predictive value was 73.7%, and negative predictive value was 78.9%. Conclusions: Model-based SI ruled in and ruled out sepsis with fairly high sensitivity and specificity in our critically ill nondiabetic patients. These findings can be used as a foundation for further, prospective investigation in this area. � 2018 Indian Journal of Critical Care Medicine | Published by Wolters Kluwer - Medknow. Final 2023-05-29T06:51:58Z 2023-05-29T06:51:58Z 2018 Article 10.4103/ijccm.IJCCM_92_18 2-s2.0-85049197381 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049197381&doi=10.4103%2fijccm.IJCCM_92_18&partnerID=40&md5=d8c480980ef9cfded942009915437b49 https://irepository.uniten.edu.my/handle/123456789/23806 22 6 402 407 All Open Access, Bronze, Green Wolters Kluwer Medknow Publications Scopus |
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antibiotic agent; corticosteroid; glucose; hypertensive factor; infusion fluid; inotropic agent; insulin; adult; Article; artificial ventilation; clinical article; cohort analysis; controlled study; diagnostic value; female; glucose blood level; hospital admission; human; inotropism; insulin dependent diabetes mellitus; insulin infusion; insulin sensitivity; intensive care unit; male; middle aged; non insulin dependent diabetes mellitus; predictive value; receiver operating characteristic; renal replacement therapy; retrospective study; sensitivity and specificity; sepsis |
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57189369133 |
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57189369133 Shukeri W.F.W.M. Mat-Nor M.B. Jamaludin U.K. Suhaimi F. Razak N.N.A. Ralib A.M. |
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Article |
| author |
Shukeri W.F.W.M. Mat-Nor M.B. Jamaludin U.K. Suhaimi F. Razak N.N.A. Ralib A.M. |
| spellingShingle |
Shukeri W.F.W.M. Mat-Nor M.B. Jamaludin U.K. Suhaimi F. Razak N.N.A. Ralib A.M. Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study |
| author_sort |
Shukeri W.F.W.M. |
| title |
Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study |
| title_short |
Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study |
| title_full |
Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study |
| title_fullStr |
Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study |
| title_full_unstemmed |
Levels and diagnostic value of model-based insulin sensitivity in sepsis: A preliminary study |
| title_sort |
levels and diagnostic value of model-based insulin sensitivity in sepsis: a preliminary study |
| publisher |
Wolters Kluwer Medknow Publications |
| publishDate |
2023 |
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1806426137635586048 |
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13.214268 |