Virtual Trial and Monte Carlo Analysis of Model-Based Glycaemic Control Protocol With Reduced Nursing Effort

Abstract

Tight glycaemic management has been shown to be beneficial to the outcomes of patients receiving intensive care. However, tight glycaemic control (TGC) protocol within intensive care (ICU) comes with a high clinical demand, namely high nursing effort. Thus, there is a need for a protocol that is safe, effective, robust, yet does not require a high nursing effort. A less intensive protocol is designed to use a combination of subcutaneous long-acting insulin (glargine) with IV insulin bolus and only requires blood glucose (BG) measurements every 4 hours while maintaining measurement within 4.0-6.1 mmol/L.

<p>Assessment of Glycemic Control Protocol (STAR) Through Compliance Analysis Amongst Malaysian ICU Patients</p>

“…These considerations require further study and consultation with clinical staff, although clinically validated virtual trials show the potential. 34,43,50,[57][58][59][60][61][62] Finally, except for improving compliance, specifically in insulin delivery, there was no clear pattern across the years. This result clearly shows the STAR protocol was taken up and that confidence in its insulin dosing rose over time with nursing and clinical staff.…”