Modeling continuous glucose monitoring (CGM) data during sleep

Biostatistics ◽  
2020 ◽  
Author(s):  
Irina Gaynanova ◽  
Naresh Punjabi ◽  
Ciprian Crainiceanu
Keyword(s):  
Blood Glucose ◽  
Sleep Onset ◽  
Glucose Monitoring ◽  
Model Parameters ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Continuous Glucose Monitors ◽  
Study Participants ◽  
Glucose Dynamics

Summary We introduce a multilevel functional Beta model to quantify the blood glucose levels measured by continuous glucose monitors for multiple days in study participants with type 2 diabetes mellitus. The model estimates the subject-specific marginal quantiles, quantifies the within- and between-subject variability, and produces interpretable parameters of blood glucose dynamics as a function of time from the actigraphy-estimated sleep onset. Results are validated via simulations and by studying the association between the estimated model parameters and hemoglobin A1c, the gold standard for assessing glucose control in diabetes.

Advantages and Disadvantages of Realtime Continuous Glucose Monitoring in People with Type 2 Diabetes

2012 ◽  
Vol 08 (01) ◽  
pp. 22 ◽  
Author(s):  
M Susan Walker ◽  
Stephanie J Fonda ◽  
Sara Salkind ◽  
Robert A Vigersky ◽  
◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glucose Levels ◽  
Advantages And Disadvantages ◽  
Blood Glucose Levels

Previous research has shown that realtime continuous glucose monitoring (RT-CGM) is a useful clinical and lifestyle aid for people with type 1 diabetes. However, its usefulness and efficacy for people with type 2 diabetes is less known and potentially controversial, given the continuing controversy over the efficacy of self-monitoring of blood glucose (SMBG) in this cohort. This article reviews theextantliterature on RT-CGM for people with type 2 diabetes, and enumerates several of the advantages and disadvantages of this technology from the perspective of providers and patients. Even patients with type 2 diabetes who are not using insulin and/or are relatively well controlled on oral medications have been shown to spend a significant amount of time each day in hyperglycemia. Additional tools beyond SMBG are necessary to enable providers and patients to clearly grasp and manage the frequency and amplitude of glucose excursions in people with type 2 diabetes who are not on insulin. While SMBG is useful for measuring blood glucose levels, patients do not regularly check and SMBG does not enable many to adequately manage blood glucose levels or capture marked and sustained hyperglycemic excursions. RT-CGM systems, valuable diabetes management tools for people with type 1 diabetes or insulin-treated type 2 diabetes, have recently been used in type 2 diabetes patients. Theextantstudies, although few, have demonstrated that the use of RT-CGM has empowered people with type 2 diabetes to improve their glycemic control by making and sustaining healthy lifestyle choices.

MO633GLYCAEMIC MARKERS IN PATIENTS WITH TYPE 2 DIABETES UNDERGOING HAEMODIALYSIS EVALUATED BY LONG-TERM CONTINUOUS GLUCOSE MONITORING*

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Tobias Bomholt ◽  
Marianne Rix ◽  
Thomas Peter Almdal ◽  
Filip K Knop ◽  
Susanne Rosthøj ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Monitoring ◽  
Control Group ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Sensor Glucose ◽  
The Mean ◽  
Mean Blood Glucose

Abstract Background and Aims The reliability of haemoglobin A1c (HbA1c) as a glycaemic marker in patients receiving haemodialysis (HD) remains unknown. To assess accuracy, we compared HbA1c and fructosamine levels with interstitial glucose levels measured by continuous glucose monitoring (CGM) in patients with type 2 diabetes receiving HD. Method The HD group (maintenance HD and type 2 diabetes) comprised 30 patients who completed the study period of 17 weeks; the control group (type 2 diabetes and an estimated glomerular filtration rate >60 mL/min/1.73 m2) comprised 36 individuals. CGM (Ipro2®, Medtronic) for periods up to seven days was performed five times (with four weeks intervals) during a 16-week period. HbA1c and fructosamine were measured at week 17. The mean sensor glucose from CGM was compared with the measured HbA1c, its estimated mean blood glucose (eMBGA1c) and fructosamine levels. Results In the HD group, the mean sensor glucose from CGM was 1.4 (95% confidence interval [CI]: 1.0–1.8) mmol/L higher than the eMBGA1c, whereas the difference was 0.1 mmol/L (95% CI: -0.1–[0.4]; P<0.001) in the control group. Adjusted for the mean sensor glucose, HbA1c was -7.3 (95% CI: -10.0–[-4.7]) mmol/mol lower in the HD group than in controls (P<0.001), whereas no difference was detected for fructosamine (P=0.64). Conclusion HbA1c evaluated by CGM underestimates mean blood glucose levels in patients receiving maintenance HD; fructosamine appears to be more accurate. CGM-assessed blood glucose could complement or replace HbA1c in patients where HbA1c underestimates blood glucose levels.

scholarly journals Dynamic changes in nocturnal blood glucose levels are associated with sleep-related features in patients with obstructive sleep apnea

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jung-Ick Byun ◽  
Kwang Su Cha ◽  
Ji Eun Jun ◽  
Tae-Joon Kim ◽  
Ki-Young Jung ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Blood Glucose ◽  
Sleep Apnea ◽  
Sleep Onset ◽  
Glucose Monitoring ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Delta Band ◽  
Obstructive Sleep ◽  
Intermittent Hypoxemia

Abstract Obstructive sleep apnea (OSA) has a bidirectional relationship with insulin resistance conditions; however, the mechanism remains unclear. This study aimed to compare dynamic nocturnal glucose changes among patients with OSA of varying levels of severity and evaluate temporal changes associated with the cardinal features of OSA (sympathetic hyperactivation, intermittent hypoxemia, and sleep fragmentation) in nondiabetic subjects. Nocturnal glucose was measured with a continuous glucose monitoring device every 5 min during polysomnography (PSG). The OSA features were evaluated using heart rate variability (HRV), minimum saturation, and electroencephalography. Eleven subjects with moderate to severe OSA and 12 subjects with no or mild OSA were evaluated. Those with moderate to severe OSA showed an increasing trend in blood glucose levels after sleep onset, whereas those without or with mild OSA showed a decreasing trend (F = 8.933, p < 0.001). Delta band power also showed different trends during sleep between the two groups (F = 2.991, p = 0.009), and minimum saturation remained lower in the moderate to severe OSA group than in the no or mild OSA group. High degrees of coupling between nocturnal glucose levels and each OSA feature were observed. Altered trends in nocturnal glucose in moderate to severe OSA may reflect glucose intolerance and result in metabolic consequences. Managing the features of sleep-related OSA may have implications for metabolic management in the future.

THE REGULATION OF THE BLOOD GLUCOSE LEVELS BY TYPE-2 FUZZY CONTROLLER

2017 ◽  
Vol 29 (03) ◽  
pp. 1750022 ◽  
Author(s):  
Aida Zeighami ◽  
Abdolhossein Ayoubi
Keyword(s):  
Blood Glucose ◽  
Fuzzy Controller ◽  
Three Dimensional ◽  
Model Parameters ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Special Rules ◽  
Small Change ◽  
Sugar Levels

It is essential to control accurately the critical variables in patients whose normal control systems have been faced with trouble. Vital parameters were different for different people; also with respect to similar changes in the parameters, the responses were different. This issue led to changes in the model parameters. It should be noted that even a small change in some of the model parameters can lead to death of patients. Therefore, the purpose of this study was to design a controller which was robust with respect to model parameter changes and disturbances entered to the system; this controller must be able to control their blood sugar levels in a suitable settling time. One of the issues discussed in this paper is type-2 fuzzy method, which is to regulate blood glucose levels. The use of type-2 fuzzy systems allows us to model the effects of uncertainty in the systems which are based on special rules. It also gives us an opportunity to minimize the uncertainty effects, but unfortunately, because of the complexity in use and comprehension of type-2 fuzzy sets than type-1, they were less used. These complexities are due to its three-dimensional nature and the direct dependence of its relations to the development principles; this is how its computational complexity is made.

scholarly journals Glucose levels between the anterior chamber of the eye and blood are correlated based on blood glucose dynamics

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0256986
Author(s):  
Toshihide Kurihara ◽  
Deokho Lee ◽  
Ari Shinojima ◽  
Taku Kinoshita ◽  
Saori Nishizaki ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Anterior Chamber ◽  
Metabolic Diseases ◽  
Glucose Monitoring ◽  
University Hospital ◽  
Blood Glucose Monitoring ◽  
Monitoring Site ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Glucose Dynamics

Glycemic control is essential to manage metabolic diseases such as diabetes. Frequent measurements of systemic glucose levels with prompt managements can prevent organ damages. The eye is a glucose highly demanding organ in our body, and the anterior chamber (AC) in the eye has been suggested for a noninvasive blood glucose monitoring site. However, calculating blood glucose levels from measuring glucose levels in AC has been difficult and unclear. In this study, we aimed to examine glucose levels from AC and find a correlation with blood glucose levels. A total of 30 patients with cataracts (men and women, study 1; 7 and 3, study 2; 9 and 11) who visited Keio University Hospital from 2015 to 2018 and agreed to participate in this study were recruited. Glucose levels from AC and the blood were examined by a UV-hexokinase or H2O2-electrode method before/during the cataract surgery. These values were analyzed with regression analyses depending on the groups (blood glucose-ascending and descending groups). In the blood glucose-descending group, glucose levels from AC were strongly correlated with blood glucose levels (a high R2 value, 0.8636). However, the relatively moderate correlation was seen in the blood glucose-ascending group (a low R2 value, 0.5228). Taken together, we showed different correlation ratios on glucose levels between AC and the blood, based on blood glucose dynamics. Stacking data regarding this issue would enable establishing noninvasive blood glucose monitoring from measuring glucose levels in AC more correctly, which will be helpful for proper and prompt managements for glucose-mediated complications.

Efeitos dos Programas de Treinamento Aeróbio, de Força e Combinado na Glicose Sanguínea em Diabéticos do Tipo 2: uma Revisão Sistemática/ Effects of Aerobic, Strength and Combined Programs Training on Blood Glucose in Type 2 Diabetic: a Systematic Review.

1970 ◽  
Vol 5 (1) ◽  
pp. 61-74 ◽  
Author(s):  
Alexandre de Souza E Silva ◽  
Maria Paula Gonçalves Mota
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Training Program ◽  
Aerobic Training ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Pubmed Database

O trabalho tem como objetivo analisar os estudos que avaliaram os efeitos dos programas de treinamento aeróbio, força e combinado nos níveis de glicose sanguínea em indivíduos com diabetes do tipo 2. Foi utilizado o método de revisão sistemática, sendo utilizada a base de dados PubMed. As palavras chaves utilizadas para pesquisa foram training and diabetes. Foram identificados 484 artigos originais. Apenas 17 estudos respeitaram os critérios de inclusão. Os resultados evidenciam que os programas de treinamento aeróbio diminuíram os níveis de glicose. O programa de treinamento de força também foi favorável à diminuição dos níveis de glicose sanguínea. Já o programa de treinamento combinado não demonstrou efeitos favoráveis no controle da glicose sanguínea. Conclui-se que o programa de treinamento aeróbio e de força ajudam a controlar os níveis de glicose sanguínea em indivíduos com diabetes do tipo 2. Palavras-chave: diabetes mellitus, treinamento, glicose.ABSTRACTThe study aims to analyze the studies that evaluated the effects of aerobic, strength and combined programs training in blood glucose levels in people with type 2 diabetes. We used a systematic review method and is used to PubMed database. The key words used for searching were training and diabetes. We identified 484 original articles. Only 17 studies complied with the inclusion criteria. The results show that aerobic training programs decreased glucose levels. The strength training program was also favorable to decrease in blood glucose levels. But the combined training program has not shown favorable effects on blood glucose control. We conclude that the aerobic training and strength helps control blood glucose levels in individuals with type 2 diabetes. Keywords: diabetes mellitus, training, glucose.

scholarly journals Pharmaceutical hit of anti type 2 Diabetes mellitus on the phenolic extract of Malaka (Phyllanthus emblica L.) flesh

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Musri Musman ◽  
Mauli Zakia ◽  
Ratu Fazlia Inda Rahmayani ◽  
Erlidawati Erlidawati ◽  
Safrida Safrida
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Blood Glucose ◽  
Phyllanthus Emblica ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Phenolic Extract

Abstract Background Ethnobotany knowledge in a community has shaped local wisdom in utilizing plants to treat diseases, such as the use of Malaka (Phyllanthus emblica) flesh to treat type 2 diabetes. This study presented evidence that the phenolic extract of the Malaka flesh could reduce blood sugar levels in the diabetic induced rats. Methods The phenolic extract of the P. emblica was administrated to the glucose-induced rats of the Wistar strain Rattus norvegicus for 14 days of treatment where the Metformin was used as a positive control. The data generated were analyzed by the two-way ANOVA Software related to the blood glucose level and by SAS Software related to the histopathological studies at a significant 95% confidence. Results The phenolic extract with concentrations of 100 and 200 mg/kg body weight could reduce blood glucose levels in diabetic rats. The post hoc Dunnet test showed that the administration of the extract to the rats with a concentration of 100 mg/kg body weight demonstrated a very significant decrease in blood glucose levels and repaired damaged cells better than administering the extract at a concentration of 200 mg/kg weight body. Conclusion The evidence indicated that the phenolic extract of the Malaka flesh can be utilized as anti type 2 Diabetes mellitus without damaging other organs.

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