Creating smooth SI. B-spline basis function representations of insulin sensitivity

Publication date: July 2018 Source:Biomedical Signal Processing and Control, Volume 44 Author(s): Kent W. Stewart, Christopher G. Pretty, Geoffrey M. Shaw, J. Geoffrey Chase In the intensive care unit (ICU), stress-induced insulin resistance leading to hyperglycemia is commonplace. If safe and effective glycemic control (GC) can be provided, a significant reduction in the negative effects of dysglycemia can be achieved. The Intensive Control Insulin-Nutrition-Glucose (ICING) model has worked particularly well in guiding patient-specific GC. The current method to identify patient- and time- specific insulin sensitivity (SI) with this model employs a discrete stepwise hourly function, which is effective, but not physiologically representative at hourly transitions. 2nd Order B-spline basis functions (BF) are investigated as a more continuous and physiologically relevant alternative for two different cohorts of patient data (Benchmark, 20 patients; Stochastic TARgeted (STAR) sub-cohort, 72 patients). Various knot-widths (KW) of 2nd Order B-spline BFs were investigated and compared to the currently used step function BF in terms of physiological relevance, identifiability, robustness to false measurements, and susceptibility to noise to ensure the most physiologically realistic representation of SI. The 180 min KW 2nd Order B-spline BFs provided the most physiologically realistic fit to the blood glucose (BG) measurements in both cohorts (Standard Deviation of relative fi...
Source: Biomedical Signal Processing and Control - Category: Biomedical Science Source Type: research