A Physiological Intensive Control Insulin-Nutrition-Glucose (ICING) Model Validated in Critically Ill Patients Jessica Lin a , Normy N. Razak b , Christopher G. Pretty b , Aaron Le Compte b , Paul Docherty b , Jacquelyn D. Parente b , Geoffrey M. Shaw c , Christopher E. Hann b , J. Geoffrey Chase b a Department of Medicine, University of Otago Christchurch, New Zealand b Center for Bioengineering, University of Canterbury, New Zealand c Department of Intensive Care Medicine, Christchurch Hospital, New Zealand Abstract Intensive insulin therapy (IIT) and tight glycaemic control (TGC), particu- larly in intensive care units (ICU), are the subjects of increasing and con- troversial debate in recent years. Model-based TGC has shown potential in delivering safe and tight glycaemic management, all the while limiting hypoglycaemia. A comprehensive, more physiologically relevant I ntensive C ontrol I nsulin-N utrition-G lucose (ICING) model is presented and validated using data from critically ill patients. Two existing glucose-insulin models are reviewed and formed the basis for the ICING model. Model limitations are discussed with respect to relevant physiology, pharmacodynamics and TGC practicality. Model identifiability issues are carefully considered for clinical settings. This article also contains significant reference to relevant physiology and clinical literature, as well as some references to the modeling efforts in this field. Identification of critical constant population parameters were performed Preprint submitted to Computer Methods and Programs in BiomedicineSeptember 16, 2010