Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.

<h4>Introduction</h4>This study examines the likelihood and evolution of overall and hypoglycemia-inducing variability of insulin sensitivity in ICU patients based on diagnosis and day of stay.<h4>Materials and methods</h4>An analysis of model-based insulin sensitivity for n=...

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Autores principales:	Tamás Ferenci, Balázs Benyó, Levente Kovács, Liam Fisk, Geoffrey M Shaw, J Geoffrey Chase
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/886abae87a2e4d039fa71edda83717d8
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spelling	oai:doaj.org-article:886abae87a2e4d039fa71edda83717d82021-11-18T07:56:31ZDaily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.1932-620310.1371/journal.pone.0057119https://doaj.org/article/886abae87a2e4d039fa71edda83717d82013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23437328/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4>This study examines the likelihood and evolution of overall and hypoglycemia-inducing variability of insulin sensitivity in ICU patients based on diagnosis and day of stay.<h4>Materials and methods</h4>An analysis of model-based insulin sensitivity for n=390 patients in a medical ICU (Christchurch, New Zealand). Two metrics are defined to measure the variability of a patient's insulin sensitivity relative to predictions of a stochastic model created from the same data for all patients over all days of stay. The first selectively captures large increases related to the risk of hypoglycemia. The second captures overall variability. Distributions of per-patient variability scores were evaluated over different ICU days of stay and for different diagnosis groups based on APACHE III: operative and non-operative cardiac, gastric, all other. Linear and generalized linear mixed effects models assess the statistical significance of differences between groups and over days.<h4>Results</h4>Variability defined by the two metrics was not substantially different. Variability was highest on day 1, and decreased over time (p<0.0001) in every diagnosis group. There were significant differences between some diagnosis groups: non-operative gastric patients were the least variable, while cardiac (operative and non-operative) patients exhibited the highest variability.<h4>Conclusions</h4>This study characterizes the variability and evolution of insulin sensitivity in critically ill patients, and may help inform the clinical management of metabolic dysfunction in critical care.Tamás FerenciBalázs BenyóLevente KovácsLiam FiskGeoffrey M ShawJ Geoffrey ChasePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e57119 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tamás Ferenci Balázs Benyó Levente Kovács Liam Fisk Geoffrey M Shaw J Geoffrey Chase Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
description	<h4>Introduction</h4>This study examines the likelihood and evolution of overall and hypoglycemia-inducing variability of insulin sensitivity in ICU patients based on diagnosis and day of stay.<h4>Materials and methods</h4>An analysis of model-based insulin sensitivity for n=390 patients in a medical ICU (Christchurch, New Zealand). Two metrics are defined to measure the variability of a patient's insulin sensitivity relative to predictions of a stochastic model created from the same data for all patients over all days of stay. The first selectively captures large increases related to the risk of hypoglycemia. The second captures overall variability. Distributions of per-patient variability scores were evaluated over different ICU days of stay and for different diagnosis groups based on APACHE III: operative and non-operative cardiac, gastric, all other. Linear and generalized linear mixed effects models assess the statistical significance of differences between groups and over days.<h4>Results</h4>Variability defined by the two metrics was not substantially different. Variability was highest on day 1, and decreased over time (p<0.0001) in every diagnosis group. There were significant differences between some diagnosis groups: non-operative gastric patients were the least variable, while cardiac (operative and non-operative) patients exhibited the highest variability.<h4>Conclusions</h4>This study characterizes the variability and evolution of insulin sensitivity in critically ill patients, and may help inform the clinical management of metabolic dysfunction in critical care.
format	article
author	Tamás Ferenci Balázs Benyó Levente Kovács Liam Fisk Geoffrey M Shaw J Geoffrey Chase
author_facet	Tamás Ferenci Balázs Benyó Levente Kovács Liam Fisk Geoffrey M Shaw J Geoffrey Chase
author_sort	Tamás Ferenci
title	Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
title_short	Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
title_full	Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
title_fullStr	Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
title_full_unstemmed	Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
title_sort	daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/886abae87a2e4d039fa71edda83717d8
work_keys_str_mv	AT tamasferenci dailyevolutionofinsulinsensitivityvariabilitywithrespecttodiagnosisinthecriticallyill AT balazsbenyo dailyevolutionofinsulinsensitivityvariabilitywithrespecttodiagnosisinthecriticallyill AT leventekovacs dailyevolutionofinsulinsensitivityvariabilitywithrespecttodiagnosisinthecriticallyill AT liamfisk dailyevolutionofinsulinsensitivityvariabilitywithrespecttodiagnosisinthecriticallyill AT geoffreymshaw dailyevolutionofinsulinsensitivityvariabilitywithrespecttodiagnosisinthecriticallyill AT jgeoffreychase dailyevolutionofinsulinsensitivityvariabilitywithrespecttodiagnosisinthecriticallyill
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Daily evolution of insulin sensitivity variability with respect to diagnosis in the critically ill.

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