Glycemic Control in Critically Ill Patients Effect of Delay in Insulin Administration

Several recent studies have established a correlation between tight glucose control and decreased perioperative morbidity and mortality in surgical and critically ill patients. We hypothesize that a progressive increase in delay in implementing insulin infusion rate changes would result in a progressively longer time to target glucose level and a progressive decrease in the percentage of time spent within a target glucose range. We formulate a mathematical model of glucose-insulin regulation, validate it with patient data, and use it to conclude that progressive delays in implementing insulin infusion rates result in a progressively longer time to target and poorer glycemic control in all three simulated patient types (normal, Type 1 and Type 2 diabetes mellitus)