Medicine:Glucommander
Glucommander is a computer-directed method of inpatient glucose management.[1]
Development
Glucommander's software concept originated from an article published in 1982 by White et al.[2] That article presented a complex set of orders for determining the basal insulin requirements in pediatric patients using an insulin pump.
When data were graphed, it was obvious that a linear regression with an intercept of 60 and a slope, or multiplier, of 0.02 could resolve the complexity of the orders of White et al. to a single formula for calculation of intravenous insulin requirements: (blood glucose − 60) × 0.02 = insulin dose/h.[3] Incorporated into a bedside laptop computer system by Atlanta Diabetes Associates (Paul Davidson, Bruce Bode, and Dennis Steed), the Glucommander concept was later enhanced and commercialized into the Glucommander Plus product by Glytec.
Davidson and Bode now serve as medical advisors to Glytec LLC,[4] Food and Drug Administration (FDA) in June 2006,[5] and again in 2010 for an Enterprise version of the software.[6]
Usage
Glucommander is intended to evaluate the current and cumulative patient blood glucose values, and, based on the aggregate of those measurements, whether one or many, regulate the infusion of I.V. fluids, through an I.V. infusion pump, and drive the blood glucose level towards a predetermined target range. Once that target blood glucose range has been reached, the system's function is to recommend a titration of insulin, glucose, and saline for the purpose of maintaining the patient's blood glucose level in that target range. The system is programmed to provide intravenous dosing of glucose, saline, and insulin, as well as subcutaneous dosing of glucose and insulin.[7]
References
- ↑ Davidson, PC; Steed, RD; Bode, BW (2005). "Glucommander: a computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation.". Diabetes Care 28 (10): 2418–23. doi:10.2337/diacare.28.10.2418. PMID 16186273.
- ↑ White, NH; Skor, D; Santiago, JV (1982). "Practical closed-loop insulin delivery. A system for the maintenance of overnight euglycemia and the calculation of basal insulin requirements in insulin-dependent diabetics". Annals of Internal Medicine 97 (2): 210–3. doi:10.7326/0003-4819-97-2-210. PMID 7103278.
- ↑ Davidson, P. C.; Steed, R. D.; Bode, B. W. (2005). "Glucommander: A computer-directed intravenous insulin system shown to be safe, simple, and effective in 120,618 h of operation". Diabetes Care 28 (10): 2418–23. doi:10.2337/diacare.28.10.2418. PMID 16186273.
- ↑ [1] which manufactures the Glucommander. The company initially received clearance from U.S.
- ↑ "510(k) Premarket Notification". Accessdata.fda.gov. 2006-06-30. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=21367. Retrieved 2012-02-18.
- ↑ http://www.accessdata.fda.gov/cdrh_docs/pdf10/K101344.pdf [bare URL PDF]
- ↑ "510(k) Premarket Notification". Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=21367. Retrieved 2011-03-06.
External links
- http://care.diabetesjournals.org/content/28/10/2418.full.pdf
- http://www.accessdata.fda.gov/cdrh_docs/pdf6/K061110.pdf
- Osburne, Robert C; Davidson, Paul C; Stockton, Lawrence; Baird, Marianne; Kiblinger, Lisa; Steed, R Dennis; Diabetes Special Interest Group of the Partnership for Health and Accountability (2009). "Recent literature regarding tight glycemic control: pitfalls in the sweet debate". Critical Care 13 (2): 408. doi:10.1186/cc7750. PMID 19439054.
- https://web.archive.org/web/20110707072305/http://resources.aace.com/PDF/ID%3D20%20Pharmacy%20Medications%20References/Davidson_JDiabetesSciTechnol_2008.PDF
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