Neonatal hyperglycemia in a preterm infant managed with a subcutaneous insulin pump

2020 ◽  
Vol 77 (10) ◽  
pp. 739-744
Author(s):  
Julia D Muzzy Williamson ◽  
Brenda Thurlow ◽  
Mohamed W Mohamed ◽  
Dacotah Yokom ◽  
Luis Casas
Keyword(s):  
Blood Glucose ◽  
Preterm Infant ◽  
Glucose Concentration ◽  
Insulin Pump ◽  
Blood Glucose Concentration ◽  
Glucose Monitoring ◽  
Regular Insulin ◽  
Central Line ◽  
Subcutaneous Insulin ◽  
Neonatal Hyperglycemia

Abstract Purpose Successful use of a subcutaneous insulin pump to administer regular insulin to a preterm infant with neonatal hyperglycemia is described. Summary A 520-g female infant born at 23 weeks’ gestational age via caesarian section was noted to have elevated blood glucose concentrations ranging up to 180 mg/dL (in SI units, 10 mmol/L) on day of life (DOL) 3 and peaking on DOL 9 at 250 mg/dL (13.9 mmol/L) despite conservative glucose infusion rates. Continuous infusion of regular insulin was begun on DOL 8 and continued through DOL 44, with an average insulin infusion rate of 0.08 units/kg/h. The patient experienced blood glucose concentration lability due to multiple factors, resulting in the need for frequent and routine blood glucose concentration monitoring to minimize hypoglycemia events. On DOL 44, a subcutaneous insulin pump was placed and used to provide diluted regular insulin (25 units/mL). After 1 week, the patient’s blood glucose concentration normalized, which led to a reduction in the frequency of glucose monitoring. After 3 weeks, insulin pump use was discontinued. The patient remained euglycemic thereafter. Conclusion The use of an insulin pump resulted in decreased blood glucose checks, discontinuation of central line access, and overall better patient care.

Accuracy and precision assessment of a new blood glucose monitoring system

2016 ◽  
Vol 54 (1) ◽  
Author(s):  
Li-Nong Ji ◽  
Li-Xin Guo ◽  
Li-Bin Liu
Keyword(s):  
Blood Glucose ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Venous Blood ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Blood Samples ◽  
Glucose Testing ◽  
Blood Tests ◽  
Accuracy And Precision

AbstractBlood glucose self-monitoring by individuals with diabetes is essential in controlling blood glucose levels. The International Organization for Standardization (ISO) introduced new standards for blood glucose monitoring systems (BGMS) in 2013 (ISO 15197: 2013). The CONTOUR PLUSThis study evaluated the accuracy and precision of CONTOUR PLUS BGMS in quantitative glucose testing of capillary and venous whole blood samples obtained from 363 patients at three different hospitals.Results of fingertip and venous blood glucose measurements by the CONTOUR PLUS system were compared with laboratory reference values to determine accuracy. Accuracy was 98.1% (96.06%–99.22%) for fingertip blood tests and 98.1% (96.02%–99.21%) for venous blood tests. Precision was evaluated across a wide range of blood glucose values (5.1–17.2 mmol/L), testing three blood samples repeatedly 15 times with the CONTOUR PLUS blood glucose meter using test strips from three lots. All within-lot results met ISO criteria (i.e., SD<0.42 mmol/L for blood glucose concentration <5.55 mmol/L; CV<7.5% for blood glucose concentration ≥5.55 mmol/L). Between-lot variations were 1.5% for low blood glucose concentration, 2.4% for normal and 3.4% for high.Accuracy of both fingertip and venous blood glucose measurements by the CONTOUR PLUS system was >95%, confirming that the system meets ISO 15197: 2013 requirements.

scholarly journals Update on insulin treatment of dogs and cats with non-complicated diabetes mellitus

2018 ◽  
Vol 67 (2) ◽  
pp. 83
Author(s):  
M. N. SARIDOMICHELAKIS ◽  
M. K. CHATZIS
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glucose Concentration ◽  
Insulin Treatment ◽  
Blood Glucose Concentration ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Insulin Administration ◽  
Tight Control ◽  
Insulin Glargin

Diabetes mellitus is a common endocrine disease of dogs and cats. Treatment is mainly based on insulin administration and dietary modifications. The aim of this review is to provide updated information on insulin treatment of dogs and cats with non-complicated diabetes mellitus. During the last years, there has been significant progress in the management of this disease, thanks to the use of long-acting insulin preparations that do not cause pronounced fluctuations of blood glucose concentrations (insulin glargin and detemir) and because of the widespread use of home glucose monitoring by the owners of diabetic pets. Home glucose monitoring is based on capillary blood sampling from the ear pinnae or the foot pad and measurement of blood glucose concentration with a portable blood glucose meter. This can be done periodically (e.g. every week) to replace the traditional in-clinic blood glucose curve; in this case, blood glucose concentration is measured just before the morning insulin administration and then every 1-2 hours until the next dose (usually for 12 hours). Furthermore, especially for the cat, home glucose monitoring can be performed 3-5 times per day, on a daily basis, in order to safely adjust insulin dose and achieve tight control of hyperglycemia (i.e. blood glucose concentration between 50 and 200 mg dl-1 throughout the day). The combination of dietary management, of insulin glargine or detemir administration and of the tight control of hyperglycemia has substantially increased the proportion of cats that enter into temporal or permanent diabetic remission and can be further managed without insulin. Another important achievement is the use of continuous glucose monitoring systems to monitor interstitial fluid glucose concentrations. These devices can be used in the clinic and at home and they can measure glucose concentration every 5 minutes for up to 72 consecutive hours, thus facilitating optimal adjustment of insulin treatment.

scholarly journals Estimation of Blood Glucose Concentration During Endurance Sports

2020 ◽  
Vol 14 ◽  
Keyword(s):  
Physical Activity ◽  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Glucose Monitoring ◽  
Interstitial Tissue ◽  
Endurance Sports ◽  
Convolution Integral Equation ◽  
Deconvolution Problem

In this paper, we describe a new statistical approach to estimate blood glucose concentration along time during endurance sports based on measurements of glucose concentration in subcutaneous interstitial tissue. The final goal is the monitoring of glucose concentration in blood to maximize performance in endurance sports. Blood glucose concentration control during and after aerobic physical activity could also be useful to reduce the risk of hypoglycemia in type 1 diabetes mellitus subjects. By means of a low invasive technology known as "continuous glucose monitoring", glucose concentration in subcutaneous interstitial tissue can now be measured every five minutes. However, it can be expressed as function of blood glucose concentration along time by means of a convolution integral equation. In the training phase of the proposed approach, based on measurements of glucose concentration in both artery and subcutaneous interstitial tissue during physical activity, the parameters of the convolution kernel are estimated. Then, given a new subject performing aerobic physical activity, a deconvolution problem is solved to estimate glucose concentration in blood from continuous glucose monitoring measurements

Dispositivo de Monitoreo de Glucosa en Sangre No Invasivo mediante Infrarrojo Cercano

2021 ◽  
Author(s):  
◽  
G. Silos Chincoya
Keyword(s):  
Blood Glucose ◽  
Glucose Concentration ◽  
Near Infrared ◽  
Blood Glucose Concentration ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Signal Acquisition ◽  
Infrared Transmission ◽  
Glucose Levels ◽  
Concentration Levels

This researching study aims to report the development of a prototype device that may provide the estimation of the blood glucose concentration levels non-invasively using near-infrared transmission spectroscopy techniques. The system works in three stages: signal acquisition, calibration, and estimation of blood glucose concentration levels. The acquisition of the signal used an optical sensor based on a transimpedance circuit to obtain the different intensity changes of the emitting source in terms of voltage. The calibration of the proposed device was carried out taking as reference, the values of a commercial device that performs invasive blood glucose monitoring, with the aim of obtaining greater precision. In the last stage, the Lambert-Beer Law is mainly used to estimate glucose concentration. The proposed device presents a relationship between optical signals and variations in blood glucose levels with an accuracy of 90% in average which is statistically representative considering the class of non-invasive technology used for developing the proposed device.

scholarly journals Comparison of continuous and intermittent glucose monitoring systems in a dog with diabetic ketoacidosis: a case report

2017 ◽  
Vol 62 (No. 5) ◽  
pp. 285-291
Author(s):  
W. Kim ◽  
H. Kim ◽  
S. Kang ◽  
J. Bae ◽  
J. Choi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Case Report ◽  
Blood Glucose ◽  
Blood Glucose Concentration ◽  
Glucose Monitoring ◽  
Regular Insulin ◽  
Reactive Protein ◽  
Intermittent Measurements ◽  
Glucose Meter ◽  
Somogyi Phenomenon

A Miniature schnauzer (12 years old, neutered male) was referred for lethargy, anorexia, and oral bleeding. On initial evaluation, severe hyperglycaemia (blood glucose concentration of 34.9 mmol/l), ketonuria, systemic inflammation (fever, panting, left-shift neutrophilia, and a high C-reactive protein level of 980.97 nmol/l, abnormal pancreatic lipase immunoreactivity, and periodontitis were found. With consideration of possible insulin resistance, blood glucose (BG) levels were monitored using a portable glucose meter (q 1–3 h) and a continuous glucose monitoring system (CGMS) for 72 h (three consecutive trials); intensive insulin therapy was initiated using regular insulin (2.2 IU/kg intravenously). The insulin doses needed, based on the nadir, peak, and duration of insulin action from a traditional intermittent glucose curve were higher than those based on the CGMS results. Meanwhile, transient hyperglycaemic and hypoglycaemic periods, occurring between the intermittent measurements, were easily identified with the CGMS. Therefore, insulin resistance and the Somogyi phenomenon are less likely to occur with use of the CGMS than with intermittent BG measurements. By comparing data from a CGMS to those from an intermittent portable BG measurement system, this case report emphasises the importance and usefulness of a CGMS.

scholarly journals Feasibility Evaluation of Metamaterial Microwave Sensors for Non-Invasive Blood Glucose Monitoring

Sensors ◽  
2021 ◽  
Vol 21 (20) ◽  
pp. 6871
Author(s):  
Lukas Malena ◽  
Ondrej Fiser ◽  
Paul R. Stauffer ◽  
Tomas Drizdal ◽  
Jan Vrba ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Numerical Models ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Maximum Relative Error ◽  
Non Invasive ◽  
Unit Cells ◽  
Higher Sensitivity

The use of microwave technology is currently under investigation for non-invasive estimation of glycemia in patients with diabetes. Due to their construction, metamaterial (MTM)-based sensors have the potential to provide higher sensitivity of the phase shift of the S21 parameter (∠S21) to changes in glucose concentration compared to standard microstrip transmission line (MSTL)-based sensors. In this study, a MSTL sensor and three MTM sensors with 5, 7, and 9 MTM unit cells are exposed to liquid phantoms with different dielectric properties mimicking a change in blood glucose concentration from 0 to 14 mmol/L. Numerical models were created for the individual experiments, and the calculated S-parameters show good agreement with experimental results, expressed by the maximum relative error of 8.89% and 0.96% at a frequency of 1.99 GHz for MSTL and MTM sensor with nine unit cells, respectively. MTM sensors with an increasing number of cells show higher sensitivity of 0.62° per mmol/L and unit cell to blood glucose concentration as measured by changes in ∠S21. In accordance with the numerical simulations, the MTM sensor with nine unit cells showed the highest sensitivity of the sensors proposed by us, with an average of 3.66° per mmol/L at a frequency of 1.99 GHz, compared to only 0.48° per mmol/L for the MSTL sensor. The multi-cell MTM sensor has the potential to proceed with evaluation of human blood samples.

scholarly journals Unsupervised calibration for noninvasive glucose-monitoring devices using mid-infrared spectroscopy

2018 ◽  
Vol 11 (06) ◽  
pp. 1850038 ◽  
Author(s):  
Ryosuke Kasahara ◽  
Saiko Kino ◽  
Shunsuke Soyama ◽  
Yuji Matsuura
Keyword(s):  
Infrared Spectroscopy ◽  
Blood Glucose ◽  
Spectral Data ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Glucose Monitoring ◽  
Blood Collection ◽  
Mid Infrared ◽  
Noninvasive Glucose Monitoring ◽  
Blood Glucose Concentrations

Noninvasive, glucose-monitoring technologies using infrared spectroscopy that have been studied typically require a calibration process that involves blood collection, which renders the methods somewhat invasive. We develop a truly noninvasive, glucose-monitoring technique using mid-infrared spectroscopy that does not require blood collection for calibration by applying domain adaptation (DA) using deep neural networks to train a model that associates blood glucose concentration with mid-infrared spectral data without requiring a training dataset labeled with invasive blood sample measurements. For realizing DA, the distribution of unlabeled spectral data for calibration is considered through adversarial update during training networks for regression to blood glucose concentration. This calibration improved the correlation coefficient between the true blood glucose concentrations and predicted blood glucose concentrations from 0.38 to 0.47. The result indicates that this calibration technique improves prediction accuracy for mid-infrared glucose measurements without any invasively acquired data.

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