Insulin kinetics and the Neonatal Intensive Care Insulin–Nutrition–Glucose (NICING) model

Abstract

Background: Models of human glucose-insulin physiology have been developed for a range of uses, with similarly different levels of complexity and accuracy. STAR (Stochastic Targeted) is a modelbased approach to glycaemic control. Elevated blood glucose concentrations (hyperglycaemia) are a common complication of stress and prematurity in very premature infants, and have been associated with worsened outcomes and higher mortality. This research identifies and validates the model parameters for model-based glycaemic control in neonatal intensive care.

A multi‐objective optimal insulin bolus advisor for type 1 diabetes based on personalized model and daily diet

“…The DVs of glucose and FFA are considered to be equal to the volume of extracellular fluid calculated by (). A similar work has been reported in Dickson et al 49 …”

“…Therefore, the DV of insulin could be achieved by the estimation of plasma volume. These DV's are addressed as the percentages of the body weight in the literature for adult subjects typically with body weights of 60 to 75 kg, 37,38,47,49 although this is not practical in the case of younger subjects for instance infants and older children.…”

Safe and effective glycaemic control in premature infants: observational clinical results from the computerised STAR-GRYPHON protocol

“…The model-based insulin sensitivity is calculated using a mathematical model specifically developed to reflect the physiology and metabolism of premature infants 32. Further details can be found elsewhere32 and in online supplementary appendix 1, but the model relates measured BG to exogenous glucose and insulin intake, as well as physiological sources and clearances. Model-based insulin sensitivity describes the ‘efficiency’ of insulin-mediated glucose uptake by insulin-sensitive tissues.…”

Modelling intestinal glucose absorption in premature infants using continuous glucose monitoring data

“…The NICING (Neonatal Intensive Care Insulin-Nutrition-Glucose) model for glycaemic control in very/extremely preterm neonates is defined [24]:…”

“…All parameters are fixed, with the exception of , which is time varying and fit on an hourly basis from clinical data using integral based fitting methods [25]. Further detail on the model and its origin can be found in [24] and the online supplement of [26]. This model is structurally similar to the ICING model for adults [22], and its dynamics are considered overall reflecting of human glucose-insulin dynamics.…”