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

Jennifer L Dickson1, Jane Alsweiler2, Cameron A Gunn3

  • 1Department of Mechanical Engineering, University of Canterbury, Christchurch, New Zealand jennifer.dickson@canterbury.ac.nz.

Journal of Diabetes Science and Technology
|August 9, 2015
PubMed

Insights

This study developed a sex-based model for infant insulin secretion to improve model-based glycemic control in neonatal intensive care. Infant insulin secretion is complex and not predictable by nutritional intake alone.

Area of Science:

  • Neonatal physiology
  • Endocrinology
  • Computational biology

Background:

  • Model-based glycemic control requires accurate patient physiology models.
  • Infant glucose-insulin metabolism differs from adults and is understudied.
  • C-peptide analysis aids in developing insulin secretion models for neonatal intensive care.

Purpose of the Study:

  • To develop and validate insulin secretion models for very preterm infants.
  • To improve model-based glycemic control strategies in neonatal intensive care.
  • To investigate factors influencing insulin secretion in this population.

Main Methods:

  • Retrospective analysis of plasma C-peptide, insulin, and blood glucose concentrations in 41 hyperglycemic very preterm infants.
  • Utilized a 2-compartment model of C-peptide kinetics to estimate insulin secretion.
  • Examined insulin secretion in relation to nutritional intake, exogenous insulin, and blood glucose levels.

Main Results:

  • Insulin secretion demonstrated high inter-patient and intra-patient variability.
  • Nutritional intake (protein, dextrose) did not reliably predict insulin secretion.
  • Insulin secretion increased with blood glucose, with a stronger correlation observed in female infants.

Conclusions:

  • A sex-based insulin secretion model was successfully developed for glycemic control frameworks.
  • Nutritional intake is not a sole determinant of insulin secretion in very preterm infants.
  • Insulin secretion is influenced by a complex interplay of metabolic factors.
Abstract

Keywords:
glycemic controlinsulin secretioninsulin therapyphysiological modelingvery preterm infants

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