Target attainment through algorithm design during intravenous insulin infusion

Algorithms were designed under a single model, to attain differing designated glycemic targets during intravenous insulin infusion, and evaluated in order to justify computerization of the model. The approximate maintenance rate (MR) of insulin infusion is discovered according to rate of change of blood glucose (BG) and previous insulin infusion rate (IR). During treatment, re-assignment of IR depends on MR and BG. For each MR, a roughly sigmoidal relationship between BG and IR is specified, such that the inflection point falls approximately at a true target BG. Performance at St. Francis Hospital, Evanston, IL, was examined during use of tabular algorithms targeting three distinct BG ranges, appropriate for the treatment of hyperglycemic hyperosmolar state, diabetic ketoacidosis, or hyperglycemia accompanying other critical illness. Group membership was defined according to algorithm used for patient treatment during the first 6 months of 2012. The group geometric mean (GGM) and multiplicative surrogate standard deviation (MSSD) are reported as group measures, respectively typifying the central tendency and variability of individual patient BG distributions. Between first attainment of target range BG control and a data collection end point, BG data were evaluable during treatment courses for 58 patients. During this time frame, in the group treated with target 100-149 mg/dL, there were five episodes of BG