A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care

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dc.contributor.author Dickson, JL en
dc.contributor.author Alsweiler, Jane en
dc.contributor.author Gunn, CA en
dc.contributor.author Pretty, CG en
dc.contributor.author Chase, JG en
dc.date.accessioned 2016-09-19T00:58:42Z en
dc.date.issued 2016-01 en
dc.identifier.citation Journal of Diabetes Science and Technology 10(1):111-118 Jan 2016 en
dc.identifier.issn 1932-2968 en
dc.identifier.uri http://hdl.handle.net/2292/30399 en
dc.description.abstract Model-based glycemic control relies on sufficiency of underlying models to describe underlying patient physiology. In particular, very preterm infant glucose-insulin metabolism can differ significantly from adults, and is relatively unstudied. In this study, C-peptide concentrations are used to develop insulin-secretion models for the purposes of glycemic control in neonatal intensive care.Plasma C-peptide, insulin, and blood glucose concentrations (BGC) were retrospectively analyzed from a cohort of 41 hyperglycemic very preterm (median age 27.2 [26.2-28.7] weeks) and very low birth-weight infants (median birth weight 839 [735-1000] g). A 2-compartment model of C-peptide kinetics was used to estimate insulin secretion. Insulin secretion was examined with respect to nutritional intake, exogenous and plasma insulin concentration, and BGC.Insulin secretion was found to be highly variable between patients and over time, and could not be modeled with respect to age, weight, or protein or dextrose intake. In 13 of 54 samples exogenous insulin was being administered, and insulin secretion was lower. However, low data numbers make this result inconclusive. Insulin secretion was found to increase with BG, with a stronger association in female infants than males (R(2) = .51 vs R(2) = .13, and R(2) = .26 for the combined cohort).A sex-based insulin secretion model was created and incorporated into a model-based glycemic control framework. Nutritional intake did not predict insulin secretion, indicating that insulin secretion is a complex function of a number of metabolic factors. en
dc.format.medium Electronic en
dc.language eng en
dc.publisher SAGE Publications (UK and US) en
dc.relation.ispartofseries Journal of Diabetes Science and Technology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care en
dc.type Journal Article en
dc.identifier.doi 10.1177/1932296815596175 en
pubs.issue 1 en
pubs.begin-page 111 en
pubs.volume 10 en
dc.identifier.pmid 26253143 en
pubs.end-page 118 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 495039 en
pubs.org-id Liggins Institute en
pubs.org-id LiFePATH en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Paediatrics Child & Youth Hlth en
dc.identifier.eissn 1932-2968 en
pubs.record-created-at-source-date 2016-09-19 en
pubs.dimensions-id 26253143 en

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