- Improved Open-Loop Glucose Control With Basal Insulin Reduction 90 Minutes Before Aerobic Exercise in Patients With Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion. [Journal Article]
- DCDiabetes Care 2019; 42(5):824-831
- CONCLUSIONS: Overall, a 50-80% BRR set 90 min pre-exercise improves glucose control and decreases hypoglycemia risk during exercise better than PS at exercise onset, while not compromising the postexercise meal glucose control.
- A Novel Three-Compartmental Model for Artificial Pancreas: Development and Validation. [Journal Article]
- AOArtif Organs 2017; 41(12):E326-E336
- Closed-loop insulin delivery system, also known as artificial pancreas (AP), provides the blood glucose control in diabetic patients, enabling the automatic blood-sugar management and reducing the ri…
Closed-loop insulin delivery system, also known as artificial pancreas (AP), provides the blood glucose control in diabetic patients, enabling the automatic blood-sugar management and reducing the risks and improving the lives of people with diabetes. A new three-compartmental model of glucose-insulin interaction for AP is presented and tested in this paper. The glucose and insulin "spaces" are split into a plasma compartment and interstitial fluids compartment, respectively. The model includes an additional subcutaneous compartment and provides three explicit delays and three parameters influencing the regulatory system and correlating with the physiopathology of the patients. Two delays are related with hepatic glucose production and insulin secretion; the third delay represents the lag time in the absorption of exogenous insulin in subcutaneous tissue. The parameters regulate the system dynamics acting on the glucose utilization and the insulin secretion. The clinical data (including information on food ingestion and exogenous insulin injection) from five case studies of Type 1 diabetics are presented and used to validate the mathematical model. After training the parameters for each case study, the model well simulates the glucose level during a 4-day test. The estimated values are physiologically meaningful and provide a further insight on the subject's dysfunctions and on the state of the disease. The results have been also compared with a parallel simulation carried out by implementing a previous two-compartmental model. The proposed algorithm produces a lower sum of the squared error between the simulated and the measured glucose concentrations over time.
- Microdialysis-Assessed Adipose Tissue Metabolism in Critically Ill Patients. [Review]
- RPRecent Pat Endocr Metab Immune Drug Discov 2017; 11(1):32-38
- CONCLUSIONS: Microneedle arrays have been already used to assess interstitial fluid glucose. Possibly, the implementation of microneedle and lab-on-a-chip technology, might complement the current use of microdialysis in the study of the interstitial space/adipose tissue metabolism in health and disease.
- The effects of crocin, insulin and their co-administration on the heart function and pathology in streptozotocin-induced diabetic rats. [Journal Article]
- AJAvicenna J Phytomed 2016 Nov-Dec; 6(6):658-670
- CONCLUSIONS: The results showed cardioprotective effects of crocin and insulin in STZ-induced diabetic rats. The antioxidant and anti-hyperglycemic properties of crocin and insulin may be involved in their cardioprotective actions.
- Characteristics of blood glucose excursions in type 2 diabetes mellitus patients with three different Traditional Chinese Medicine syndromes. [Journal Article]
- JTJ Tradit Chin Med 2015; 35(5):537-45
- CONCLUSIONS: Patients with Qi and Yin deficiency syndrome had a more stable blood glucose profile, as glycemic variability was higher in those with intrinsic Damp syndrome and those with Yin deficiency and internal Heat syndrome.
- Bioavailability of insulin detemir and human insulin at the level of peripheral interstitial fluid in humans, assessed by open-flow microperfusion. [Clinical Trial]
- DODiabetes Obes Metab 2015; 17(12):1166-72
- CONCLUSIONS: OFM proved useful for target tissue measurements of human insulin and the analogue insulin detemir. Our tissue data confirm a highly effective retention of insulin detemir in the vascular compartment. The higher insulin detemir relative to human insulin tissue concentrations at comparable pharmacodynamics, however, indicate that the lower potency of insulin detemir in humans is attributable to a reduced effect in peripheral insulin-sensitive tissues and is consistent with the reduced in vitro receptor affinity.
- Open flow microperfusion: pharmacokinetics of human insulin and insulin detemir in the interstitial fluid of subcutaneous adipose tissue. [Journal Article]
- DODiabetes Obes Metab 2015; 17(2):121-7
- CONCLUSIONS: By using OFM we were able to monitor albumin-bound insulin detemir directly in the ISF of subcutaneous tissue and confirm its delayed transendothelial passage to a peripheral site of action.
- Blood glucose level reconstruction as a function of transcapillary glucose transport. [Journal Article]
- CBComput Biol Med 2014; 53:171-8
- A diabetic patient occasionally undergoes a detailed monitoring of their glucose levels. Over the course of a few days, a monitoring system provides a detailed track of their interstitial fluid gluco…
A diabetic patient occasionally undergoes a detailed monitoring of their glucose levels. Over the course of a few days, a monitoring system provides a detailed track of their interstitial fluid glucose levels measured in their subcutaneous tissue. A discrepancy in the blood and interstitial fluid glucose levels is unimportant because the blood glucose levels are not measured continuously. Approximately five blood glucose level samples are taken per day, and the interstitial fluid glucose level is usually measured every 5min. An increased frequency of blood glucose level sampling would cause discomfort for the patient; thus, there is a need for methods to estimate blood glucose levels from the glucose levels measured in subcutaneous tissue. The Steil-Rebrin model is widely used to describe the relationship between blood and interstitial fluid glucose dynamics. However, we measured glucose level patterns for which the Steil-Rebrin model does not hold. Therefore, we based our research on a different model that relates present blood and interstitial fluid glucose levels to future interstitial fluid glucose levels. Using this model, we derived an improved model for calculating blood glucose levels. In the experiments conducted, this model outperformed the Steil-Rebrin model while introducing no additional requirements for glucose sample collection. In subcutaneous tissue, 26.71% of the calculated blood glucose levels had absolute values of relative differences from smoothed measured blood glucose levels less than or equal to 5% using the Steil-Rebrin model. However, the same difference interval was encountered in 63.01% of the calculated blood glucose levels using the proposed model. In addition, 79.45% of the levels calculated with the Steil-Rebrin model compared with 95.21% of the levels calculated with the proposed model had 20% difference intervals.
- Can glucose be monitored accurately at the site of subcutaneous insulin delivery? [Review]
- JDJ Diabetes Sci Technol 2014; 8(3):568-74
- Because insulin promotes glucose uptake into adipocytes, it has been assumed that during measurement of glucose at the site of insulin delivery, the local glucose level would be much lower than syste…
Because insulin promotes glucose uptake into adipocytes, it has been assumed that during measurement of glucose at the site of insulin delivery, the local glucose level would be much lower than systemic glucose. However, recent investigations challenge this notion. What explanations could account for a reduced local effect of insulin in the subcutaneous space? One explanation is that, in humans, the effect of insulin on adipocytes appears to be small. Another is that insulin monomers and dimers (from hexamer disassociation) might be absorbed into the circulation before they can increase glucose uptake locally. In addition, negative cooperativity of insulin action (a lower than expected effect of very high insulin concentrations)may play a contributing role. Other factors to be considered include dilution of interstitial fluid by the insulin vehicle and the possibility that some of the local decline in glucose might be due to the systemic effect of insulin. With regard to future research, redundant sensing units might be able to quantify the effects of proximity, leading to a compensatory algorithm. In summary, when measured at the site of insulin delivery, the decline in subcutaneous glucose level appears to be minimal, though the literature base is not large. Findings thus far support (1) the development of integrated devices that monitor glucose and deliver insulin and (2) the use of such devices to investigate the relationship between subcutaneous delivery of insulin and its local effects on glucose. A reduction in the number of percutaneous devices needed to manage diabetes would be welcome.
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- [Recent advances of monitoring and glycaemia control during early postoperative period in patients after pancreas surgery]. [Clinical Trial]
- ARAnesteziol Reanimatol 2013 Sep-Oct; (5):30-4
- Recently new technologies of diagnostics and correction of carbohydrates metabolism disturbances are introduced in the ICU to improve the safety for patients during intensive care. 33 patients after …
Recently new technologies of diagnostics and correction of carbohydrates metabolism disturbances are introduced in the ICU to improve the safety for patients during intensive care. 33 patients after pancreas surgery were included into the study 13 patients (39%) had underlying diabetes mellitus. Glucose level changes in the interstitial liquid of the subcutaneous fat during postoperative period were monitored by system of CGM Medtronic MiniMed Guardian RT, MiniMed Paradigm Real-time. Valid values of glucose were from 4.1 to 10.1 mmol/L. Episodes of glucose level increasing occurred in 94% of patients in postoperative period after pancreas surgery. Average level of glucose was within the limits of valid values. However in 64% of cases patients needed insulin therapy Used systems of continuous glucose monitoring in the ICU allow improving the safety for patients receiving artificial nutrition and intravenous insulin therapy.