scholarly journals Meal Disturbance Effect on Control of Blood Glucose Level for Critically-ill Patients using In-silico Works

Author(s):  
N F M Yusof ◽  
A M Som ◽  
S A Ali ◽  
N H Azman
Author(s):  
Lídia Miranda Brinati ◽  
Carla Fátima Januário ◽  
Paula Coelho Balbino ◽  
Tamara Gonçalves Rezende Macieira ◽  
Silvia Almeida Cardoso ◽  
...  

2020 ◽  
Author(s):  
Shan Lin ◽  
Shanhui Ge ◽  
Wanmei He ◽  
Mian Zeng

Abstract Background: Effect of diabetes and optimal range of blood glucose level on the short-term prognosis in patients with critical illnesses are currently ambiguous. We aimed to determine whether diabetes affects short-term prognosis and optimal range of blood glucose level for critically ill patients.Methods: We performed a retrospective analysis of data on 46,476 critically ill patients from the critical care database (version 1.4), collected prospectively between 2002 and 2012. Association of diabetes with 28-day mortality was assessed by inverse probability weighting based on the propensity score. Smoothing splines and threshold effect analysis were applied to explore the optimal glucose range.Results: Of the 33,680 patients enrolled in the study, 8,701 (25.83%) had diabetes. In the main analysis, the 28-day mortality was reduced by 29% (hazard ratio (HR)=0.71, 95% confidence interval (CI) 0.67-0.76) in patients with diabetes compared to those without diabetes. The E-value of 2.17 indicated robustness to unmeasured confounders. The effect of the association between with diabetes and 28-day mortality was generally in line for all subgroup variables, significant interactions were observed for glucose at ICU admission, admission type, and insulin use (Interaction P <0.05). A V-shaped relationship was observed between glucose and 28-day mortality in patients without diabetes, with the lowest 28-day mortality corresponding to the glucose level was 101.75 mg/dl (95% CI 94.64-105.80 mg/dl), and hypoglycemia or hyperglycemia should be avoided, especially in patients admitted to the surgical intensive care unit (SICU), cardiac surgery recovery unit (CSRU), and coronary care unit (CCU); for patients with diabetes, no optimal threshold for glucose was found, and elevated blood glucose does not appear to be associated with a poor prognosis, and perhaps may be beneficial except for CCU and CSRU.Conclusions: The non-detrimental effect of diabetes on the short-term prognosis of critically ill patients was further confirmed, which would reduce 28-day mortality by approximately 29%. For patients without diabetes, the glucose level corresponding to the lowest 28-day mortality was 101.75 mg/dl (95% CI 94.64-105.80 mg/dl); however, for patients with diabetes, the appropriate optimal blood glucose threshold remains unresolved.


2020 ◽  
Author(s):  
Nur’Amanina Mohd Sohadi ◽  
Ayub Md Som ◽  
Noor Shafina Mohd Nor ◽  
Nur Farhana Mohd Yusof ◽  
Sherif Abdulbari Ali ◽  
...  

AbstractBackgroundType 1 diabetes mellitus (T1DM) occurs due to inability of the body to produce sufficient amount of insulin to regulate blood glucose level (BGL) at normoglycemic range between 4.0 to 7.0 mmol/L. Thus, T1DM patients require to do self-monitoring blood glucose (SMBG) via finger pricks and depend on exogenous insulin injection to maintain their BGL which is very painful and exasperating. Ongoing works on artificial pancreas device nowadays focus primarily on a computer algorithm which is programmed into the controller device. This study aims to simulate so-called improved equations from the Hovorka model using actual patients’ data through in-silico works and compare its findings with the clinical works.MethodsThe study mainly focuses on computer simulation in MATLAB using improved Hovorka equations in order to control the BGL in T1DM. The improved equations can be found in three subsystems namely; glucose, insulin and insulin action subsystems. CHO intakes were varied during breakfast, lunch and dinner times for three consecutive days. Simulated data are compared with the actual patients’ data from the clinical works.ResultsResult revealed that when the patient took 36.0g CHO during breakfast and lunch, the insulin administered was 0.1U/min in order to maintain the blood glucose level (BGL) in the safe range after meal; while during dinner time, 0.083U/min to 0.1 U/min of insulins were administered in order to regulate 45.0g CHO taken during meal. The basal insulin was also injected at 0.066U/min upon waking up time in the early morning. The BGL was able to remain at normal range after each meal during in-silico works compared to clinical works.ConclusionsThis study proved that the improved Hovorka equations via in-silico works can be employed to model the effect of meal disruptions on T1DM patients, as it demonstrated better control as compared to the clinical works.


Molecules ◽  
2021 ◽  
Vol 26 (10) ◽  
pp. 3043
Author(s):  
Furqan Ahmad Saddique ◽  
Sana Aslam ◽  
Matloob Ahmad ◽  
Usman Ali Ashfaq ◽  
Muhammad Muddassar ◽  
...  

Diabetes mellitus (DM) is a chronic disorder and has affected a large number of people worldwide. Insufficient insulin production causes an increase in blood glucose level that results in DM. To lower the blood glucose level, various drugs are employed that block the activity of the α-glucosidase enzyme, which is considered responsible for the breakdown of polysaccharides into monosaccharides leading to an increase in the intestinal blood glucose level. We have synthesized novel 2-(3-(benzoyl/4-bromobenzoyl)-4-hydroxy-1,1-dioxido-2H-benzo[e][1,2]thiazin-2-yl)-N-arylacetamides and have screened them for their in silico and in vitro α-glucosidase inhibition activity. The derivatives 11c, 12a, 12d, 12e, and 12g emerged as potent inhibitors of the α-glucosidase enzyme. These compounds exhibited good docking scores and excellent binding interactions with the selected residues (Asp203, Asp542, Asp327, His600, Arg526) during in silico screening. Similarly, these compounds also showed good in vitro α-glucosidase inhibitions with IC50 values of 30.65, 18.25, 20.76, 35.14, and 24.24 μM, respectively, which were better than the standard drug, acarbose (IC50 = 58.8 μM). Furthermore, a good agreement was observed between in silico and in vitro modes of study.


2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Habtamu Sime ◽  
Melkamu Berhane ◽  
Tsion Tilahun ◽  
Temam Kedir ◽  
Diriba Dereje ◽  
...  

BACKGROUND፡ Abnormal blood glucose level is one of the most frequently encountered problems in children with severe illnesses. However, its magnitude and outcome have rarely been determined in Ethiopia. We aimed to determine the magnitude, associated factors and outcome of dysglycemia in critically ill children admitted to Jimma Medical Center.METHODS: Prospective longitudinal study was conducted on children aged 28 days to 14 years admitted with critical illnesses at the different units of the Department of Pediatrics and Child Health of Jimma Medical Center, Southwest Ethiopia, from June to August 2019. Data were collected by trained medical personnel using structured questionnaire and analyzed using Statistical Package for Social Sciences (SPSS) windows version 20.0. Dysglycemia was considered whenever the child had a random blood sugar >150mg/dl or <45mg/dl.RESULT: Dysglycemia was seen at admission in 139/481, 28.9% children; 24 (5.0%) had hypoglycemia whereas 115 (23.9%) had hyperglycemia. The factors associated with dysglycemia at admission were severe acute malnutrition (p=002, AOR=3.09, CI=1.18,7.77), impaired mental status (p=0.003, AOR=4.63, CI=1.68, 12.71), place of residence (p=0.01, AOR=1.85, CI=1.15-2.96) and presence of diarrhea on date of admission. Among the children who had dysglycemia at admission, 16/139, 11.5% died.CONCLUSION: Dysglycemia is a common problem in critically ill children in the setting. Blood glucose level should be determined for all critically ill children, and routine empirical administration of dextrose should be minimized since most of the children with dysglycemia had hyperglycemia than hypoglycemia.


2017 ◽  
Vol 22 (5) ◽  
pp. 312-319 ◽  
Author(s):  
Shaoning Lv ◽  
Paul Ross ◽  
Kathleen Tori

2019 ◽  
pp. 52-56
Author(s):  
Yu.F. Glukhov ◽  
N.V. Krutikov ◽  
A.V. Ivanov ◽  
N.P. Muravskaya

We have studied and analyzed status and metrological supervision of blood glucose monitors, individual devices for a person’s blood glucose level measurement. It has been indicated that nowadays blood glucose monitors like other individual devices for medical measurement are not allowed to be involved in telemedicine public service. This accounts for absence of metrological supervision with these measurement devices in telemedicine. In addition, the key problem is absence of safe methods and means of remote verificaition, calibration and transmission of measurement data to health care centers. The article offers a remote test method for blood glucose monitors using a number of resistors with values correlating with measured blood glucose level. The available method has been successfully trialed in real practice.


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