ABSTRACT
In critically ill patients control of blood sugar levels with IV insulin has been shown to improve clinical outcomes in the intensive care units. We have developed an analytical framework with which to evaluate and compare IV insulin-treatment models and protocols. Performance of the analytical framework is demonstrated using protocols published by others and new protocols under development by our group.
Subject(s)
Critical Care/methods , Critical Illness/therapy , Decision Support Systems, Clinical , Drug Therapy, Computer-Assisted/methods , Hyperglycemia/drug therapy , Insulin/administration & dosage , Medical Records Systems, Computerized , Outcome Assessment, Health Care/methods , Humans , Injections, Intravenous , Treatment Outcome , UtahABSTRACT
Constantly changing diabetes care standards makes it challenging to deliver care adapted to the unique condition of the individual patient. The availability of large amounts of data from patient's electronic medical records makes it possible to individualize diabetes management. Initial design of a "patient-specific" hybrid system (physiological-causal probabilistic) of adaptive diabetes models and insulin treatment algorithms will be presented. The system is uniquely derived and tested using a diabetes data mart of about 33,000 patients.
Subject(s)
Decision Support Systems, Clinical , Diabetes Mellitus/drug therapy , Drug Therapy, Computer-Assisted/methods , Insulin/therapeutic use , Medical Records Systems, Computerized/statistics & numerical data , Precision Medicine/methods , Patient-Centered Care/methods , UtahABSTRACT
Miniaturization of clinical chemistry analyzers can empower research conducted to better understand, diagnose, manage, and cure diseases such as diabetes. For the last decade, we have been working on the design and development of miniaturized clinical chemistry devices, including a Diabetic Chip (diabetiChip). These devices measure a small array of analytes, are small, portable, fast, easy-to-operate, and inexpensive. The chosen analytical method for the diabetiChip uses bioluminescence, which is highly sensitive and specific, and is based on photon counting and specific enzymatic reactions. Bioluminescent reactions were intentionally chosen for analyzing metabolic reactions because they use some of the central nodes of metabolism, such as adenosine triphosphate. Operations of the diabetiChip's information processing ware are the focus of this paper; we show the feasibility of using a set of kinase-containing enzymatic reactions of a firefly bioluminescence-coupled glucose assay in designing the diabetiChip. We have developed and tested the feasibility of the glucose assay; the assay's analytical detection limits (before sample dilution) were 5-185 microM. Uncertainty associated with reporting a 100 microM concentration was about +/- 5 microM. The results show that an FFL bioluminescent-coupled glucose assay is promising in terms of reducing sample volume and cost. The concept of GlucoFaces in visualizing measurements of the diabetiChip is also discussed.
ABSTRACT
About 100 million Americans visit science centers each year to participate in experiential science and technology activities. There is great potential for diabetes awareness and education via the several hundreds of science centers in the United States. Most science centers tend to avoid medically related topics in part because of the difficulty in meeting the interactive goals of science center activities. The Utah Science Center (USC) is addressing these difficulties by creating environments for personal interactive activities in a range of medically related topics, including diabetes. The USC will open in early 2005 in Salt Lake City. The design of diabetes activities for the USC is reviewed: (1) activities (aims, description, stages of development, and partnerships); (2) specific stage I activities (body mass index, "feeling" hypoglycemia, and urine chemistry); and (3) conclusion.
