Development and evaluation of a glucose analyzer for a glucose controlled insulin infusion system ((Biostator).

1978 ◽  
Vol 24 (8) ◽  
pp. 1366-1372 ◽  
Author(s):  
E J Fogt ◽  
L M Dodd ◽  
E M Jenning ◽  
A H Clemens
Keyword(s):  
Blood Glucose ◽  
Whole Blood ◽  
Insulin Infusion ◽  
Full Range ◽  
Dynamic Control ◽  
On Line ◽  
The Moment ◽  
Glucose 6 Phosphate Dehydrogenase ◽  
Blood Glucose Concentrations ◽  
Infusion System

Abstract The Glucose-Controlled Insulin Infusion System (Biostator) is a modular, computerized, feedback control system for dynamic control of blood glucose concentrations in diabetics. This on-line glucose analyzer for use with whole blood utilizes a novel enzyme (glucose oxidase)-membrane configuration and an electrochemical cell to measure the H202 generated. The analyzer exhibits both short- and long-range stability, and instrument response and analyte concentration are linearly related over the full range of clinical interest. The response is fast, accurate, and precise, and permits determination of blood glucose within 2 min from the moment the blood leaves the patient. Correlation studies were completed to show the agreement between the Biostator Glucose Analyzer and the FDA's recommended hexokinase/glucose-6-phosphate dehydrogenase procedure on whole blood (e.g., average per cent recovered for 11 concentrations between 250 and 900 mg/liter was: hexokinase, 95.6%, Biostator Analyzer, 95.9%; bias and SDd, respectively, at low, normal, and high glucose values were: 12 and 41 mg/liter at the 500 mg/liter level; 4 and 52 mg/liter at the 1000 mg/liter level, and 4 and 128 mg/liter at the 4000 mg/liter level). No appreciable interference is observed with above-normal concentrations of bilirubin, uric acid, creatinine, sodium salicylate, or dextran. Platelet adhesion, which tends to decrease the useful life of the membrane, has been significantly decreased.

The effect of hyperglucagonaemia on blood glucose concentrations and on insulin requirements during fasting in insulin dependent diabetes mellitus

1983 ◽  
Vol 102 (4) ◽  
pp. 557-560
Author(s):  
W. L. Clarke ◽  
T. W. Melton ◽  
G. M. Bright
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Glucose Production ◽  
Insulin Dependent Diabetes Mellitus ◽  
Dependent Diabetes Mellitus ◽  
Insulin Requirements ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Blood Glucose Concentrations ◽  
Infusion System

Abstract. The effect of sustained hyperglucagonaemia on blood glucose concentrations and on insulin requirements was evaluated in 6 fasting insulin dependent diabetic subjects whose blood glucose concentrations were being controlled with a closed loop insulin infusion system. Subjects were iv infused initially with either saline or glucagon and subsequently with the other infusate. All determinations were performed following the period during which transient increases in glucagon stimulated glucose production have been reported to occur. Plasma glucagon concentrations were significantly higher during the glucagon study period (491±65 vs 70±13 pg/ml ± sd, P<0.001) as were blood glucose concentrations(104 ± 2 vs 84 ± 7 mg/ml ± sd, P<0.001) and insulin requirements (3.5 to 36.5 vs 0 to 2.3 mU/kg/h, P<0.05). Sustained hyperglucagonaemia continues to have an effect on glucose homeostasis for at least 2 h following the initiation of a continuous infusion.

scholarly journals Accuracy of Capillary and Arterial Whole Blood Glucose Measurements Using a Glucose Meter in Patients under General Anesthesia in the Operating Room

2017 ◽  
Vol 127 (3) ◽  
pp. 466-474 ◽  
Author(s):  
Brad S. Karon ◽  
Leslie J. Donato ◽  
Chelsie M. Larsen ◽  
Lindsay K. Siebenaler ◽  
Amy E. Wells ◽  
...  
Keyword(s):  
Blood Glucose ◽  
General Anesthesia ◽  
Operating Room ◽  
Whole Blood ◽  
Insulin Infusion ◽  
Subcutaneous Insulin ◽  
Intravenous Insulin ◽  
Diabetes Status ◽  
Glucose Meter ◽  
Arterial Glucose

Abstract Background The aim of this study was to evaluate the use of a glucose meter with surgical patients under general anesthesia in the operating room. Methods Glucose measurements were performed intraoperatively on 368 paired capillary and arterial whole blood samples using a Nova StatStrip (Nova Biomedical, USA) glucose meter and compared with 368 reference arterial whole blood glucose measurements by blood gas analyzer in 196 patients. Primary outcomes were median bias (meter minus reference), percentage of glucose meter samples meeting accuracy criteria for subcutaneous insulin dosing as defined by Parkes error grid analysis for type 1 diabetes mellitus, and accuracy criteria for intravenous insulin infusion as defined by Clinical and Laboratory Standards Institute guidelines. Time under anesthesia, patient position, diabetes status, and other variables were studied to determine whether any affected glucose meter bias. Results Median bias (interquartile range) was −4 mg/dl (−9 to 0 mg/dl), which did not differ from median arterial meter bias of −5 mg/dl (−9 to −1 mg/dl; P = 0.32). All of the capillary and arterial glucose meter values met acceptability criteria for subcutaneous insulin dosing, whereas only 89% (327 of 368) of capillary and 93% (344 of 368) arterial glucose meter values met accuracy criteria for intravenous insulin infusion. Time, patient position, and diabetes status were not associated with meter bias. Conclusions Capillary and arterial blood glucose measured using the glucose meter are acceptable for intraoperative subcutaneous insulin dosing. Whole blood glucose on the meter did not meet accuracy guidelines established specifically for more intensive (e.g., intravenous insulin) glycemic control in the acute care environment.

scholarly journals Considering Blood Dilution improves the Precision of Continuous Whole Blood Glucose Measurements

2018 ◽  
Vol 13 (4) ◽  
pp. 751-755
Author(s):  
Carsten Benesch ◽  
Mareike Kuhlenkötter ◽  
Tim Heise
Keyword(s):  
Blood Glucose ◽  
Retrospective Analysis ◽  
Whole Blood ◽  
Glucose Infusion ◽  
Dilution Factor ◽  
Continuous Measurements ◽  
Blood Dilution ◽  
And Control ◽  
Blood Glucose Concentrations ◽  
The Impact

Background:One major advantage of automated over manual clamps are continuous measurements of blood glucose concentrations (BG) allowing frequent adaptations in glucose infusion rates (GIR). However, BG measurements might be affected by changes in blood dilution. ClampArt®, a modern automated clamp device, corrects BG measurements for blood dilution, but the impact of this correction is unclear.Methods:The authors performed a retrospective analysis of BG during glucose clamps comparing values with a fixed dilution factor with those corrected for the actual blood dilution.Results:Clamp quality substantially improved with the consideration of blood dilution: Mean accuracy fell from 8.1% ± 2.9% to 4.1% ± 0.8%, precision improved from 9.6 ± 3.6 mg/dl to 3.7 ± 1.3 mg/dl and control deviation from −2.6 ± 4.2 mg/dl to 0.2 ± 0.2 mg/dl.Conclusions:Correcting continuous BG measurements for blood dilution significantly increases BG measurement and clamp quality.

scholarly journals Evaluation of portable blood glucose meters using canine and feline pooled blood samples

2016 ◽  
Vol 19 (4) ◽  
pp. 707-713 ◽  
Author(s):  
A. Mori ◽  
H. Oda ◽  
E. Onozawa ◽  
S. Shono ◽  
T. Takahashi ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Whole Blood ◽  
Glucose Oxidation ◽  
Blood Samples ◽  
Grid Analysis ◽  
Glucose Meter ◽  
Healthy Dogs ◽  
Blood Glucose Concentrations ◽  
Error Grid ◽  
Blood Glucose Meter

Abstract This study evaluated the accuracy and reproducibility of a human portable blood glucose meter (PBGM) for canine and feline whole blood. Reference plasma glucose values (RPGV) were concurrently measured using glucose oxidation methods. Fifteen healthy dogs and 6 healthy cats were used for blood sampling. Blood glucose concentrations and hematocrits were adjusted using pooled blood samples for our targeted values. A positive correlation between the PBGM and RPGV was found for both dogs (y = 0.877, x = −24.38, r = 0.9982, n = 73) and cats (y = 1.048, x = −27.06, r = 0.9984, n = 69). Acceptable results were obtained in error grid analysis between PBGM and RPGV in both dogs and cats; 100% of these results were within zones A and B. Following ISO recommendations, a PBGM is considered accurate if 95% of the measurements are within ± 15 mg/dl of the RPGV when the glucose concentration is <100 mg/dl and within ±15% when it is ≥100 mg/dl; however, small numbers of samples were observed inside the acceptable limits for both dogs (11%, 8 of 73 dogs) and cats (39%, 27 of 69 cats). Blood samples with high hematocrits induced lower whole blood glucose values measured by the PBGM than RPGV under hypoglycemic, normoglycemic, and hyperglycemic conditions in both dogs and cats. Therefore, this device is not clinically useful in dogs and cats. New PBGMs which automatically compensate for the hematocrit should be developed in veterinary practice.

Insulin does not influence muscle glycogenolysis in adrenodemedullated exercising rats

1987 ◽  
Vol 253 (4) ◽  
pp. R535-R540
Author(s):  
H. T. Yang ◽  
K. I. Carlson ◽  
W. W. Winder
Keyword(s):  
Fatty Acid ◽  
Blood Glucose ◽  
Free Fatty Acid ◽  
Plasma Insulin ◽  
Insulin Infusion ◽  
Plasma Free Fatty Acid ◽  
The Other ◽  
Elevated Plasma ◽  
Glycogen Utilization ◽  
Blood Glucose Concentrations

Previous reports have indicated that adrenodemedullated (ADM) rats exhibit an impairment in muscle glycogenolysis and elevated plasma insulin during exercise. This study was designed to determine whether the impaired muscle glycogenolysis in ADM rats is due to absence of epinephrine or to the inappropriately elevated plasma insulin. Fasted ADM rats were infused with saline, with epinephrine (0.045 micrograms . 100 g-1 . min-1), or with epinephrine + insulin (1.6, 3.3, 6.6, and 8.3 ng . 100 g-1 . min-1) during a 30-min run on the treadmill (21 m/min, 10% grade). Soleus muscle glycogen decreased from 5.1 +/- 0.2 mg/g in resting ADM rats to 4.0 +/- 0.2, 0.8 +/- 0.1, and 0.8 +/- 0.1 mg/g in the exercising saline-, epinephrine-, and epinephrine + insulin (8.3 ng . 100 g-1 . min-1)-infused rats, respectively. Glycogen utilization in gastrocnemius and red and white quadriceps muscles during exercise was likewise unaffected by insulin infusion. Blood glucose concentrations were 3.75 +/- 0.08, 2.65 +/- 0.14, 3.93 +/- 0.20, and 2.03 +/- 0.09 mM in the same groups at the end of exercise. Blood lactate was 50% lower and the blood 3-hydroxybutyrate and plasma free fatty acid concentrations were significantly higher in the ADM + saline rats than the other exercising rats. We conclude that inappropriately elevated plasma insulin does not impair epinephrine-stimulated muscle glycogenolysis in fasted ADM rats during exercise.

scholarly journals Insulin hypoglycaemia test guided by a glucose controlled insulin infusion system

1984 ◽  
Vol 106 (3) ◽  
pp. 350-356
Author(s):  
Gert Müller-Esch ◽  
Peter Ball ◽  
Karen Heidbüchel ◽  
William Graham Wood ◽  
Peter C. Scriba
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Clinical Symptoms ◽  
Insulin Dose ◽  
Control Mode ◽  
Insulin Dosage ◽  
List Type ◽  
Pituitary Insufficiency ◽  
Pituitary Tumours ◽  
Infusion System

Abstract. Insulin hypoglycaemia test (IHT) for assessment of hypothalamic-pituitary-adrenocortical (HPA) function in patients with pituitary tumours is usually performed by bolus injection of insulin, a procedure which includes the risk of overdosage and/or the need of repeated administration. This study describes that a glucose controlled insulin infusion system (GCIIS) permits to perform the IHT with standardized hypoglycaemia. Ten healthy volunteers and 10 patients with pituitary tumours were studied using the GCIIS (Biostator®) on static control (Mode 1:1, BI 35, QI 10, RI 20, FI 300). Insulin administration was discontinued and the GCIIS used only for monitoring of blood glucose (BG), when BG had fallen below 40 mg/dl and initial clinical symptoms for hypoglycaemia were observed. In controls, the GCIIS guided IHT achieved a sufficient degree of hypoglycaemia (BG 27.6 ± 2.0 mg/dl; mean ± sem) and physiological responses for GH (peak 49.4 ± 6.7 ng/ml), Prl (peak 1766 ± 614 μU/ml), ACTH (peak 76.0 ± 8.7 pg/ml) and cortisol (peak 252 ± 15 ng/ml). The total amount of insulin given was 0.115 ± 0.012 U/kg. In the patients with pituitary tumours however, the required insulin dose varied markedly from 0.090 (pituitary insufficiency) to 0.340 U/kg (Cushing's syndrome). Minimum BG obtained was 32.5 ± 1.9 mg/dl. Partial impairment of hypothalamic-pituitary function and, in particular, patients requiring exogenous cortisol supplementation during stress, could be identified. In conclusion, special advantages of the GCIIS-guided IHT are: Optimal insulin dosage with standardized hypoglycaemia due to automatic adjustment to the individual insulin sensitivity. Patients' safety by earlier recognition of due insulin discontinuation as a result of continuous blood glucose analysis.

Statistical comparison of blood glucose as determined by several test-strip procedures and by a hexokinase procedure.

1983 ◽  
Vol 29 (1) ◽  
pp. 132-135 ◽  
Author(s):  
T C Stewart ◽  
R M Kleyle
Keyword(s):  
Blood Glucose ◽  
Whole Blood ◽  
Test Strip ◽  
Statistical Tool ◽  
Statistical Comparison ◽  
Ordinal Comparison ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract We report a new statistical tool for comparing several dry-reagent strip procedures for whole blood glucose, which produce data in both digital and ordinal form, with results by the well-studied hexokinase-glucose-6-phosphate dehydrogenase procedure coupled to NAD+-NADH. Our use of "ordinal comparison unit" allows for a more equitable comparison of such data. These strip procedures produce biases of -2.21 to 1.74 ordinal comparison units over the range of glucose values corresponding to hypoglycemia and hyperglycemia, as compared with results by the hexokinase procedure, but they are essentially equivalent when compared with each other.

scholarly journals Further Evidence for the Role of Glucose as a Metabolic Regulator of Hypothalamic Gonadotropin-Releasing Hormone Pulse Generator Activity in Goats

Endocrinology ◽  
2004 ◽  
Vol 145 (7) ◽  
pp. 3239-3246 ◽  
Author(s):  
Satoshi Ohkura ◽  
Toru Ichimaru ◽  
Fumiaki Itoh ◽  
Shuichi Matsuyama ◽  
Hiroaki Okamura
Keyword(s):  
Fatty Acids ◽  
Blood Glucose ◽  
Insulin Infusion ◽  
Pulse Generator ◽  
Gnrh Release ◽  
Multiple Unit ◽  
Metabolic Signal ◽  
Blood Glucose Concentrations ◽  
Generator Activity

Abstract The present study examined the relative importance of blood glucose vs. free fatty acids as a metabolic signal regulating GnRH release as measured electrophysiologically by multiple-unit activity (MUA) in the arcuate nucleus/median eminence region in ovariectomized, estradiol-treated goats. MUA was recorded before, during, and after: 1) cellular glucoprivation by peripheral infusion of 2-deoxy-d-glucose (2DG; 25, 50, and 75 mg/kg·h, iv); 2) peripheral hypoglycemia in response to various doses (15–195 mU/kg·h, iv) of insulin infusion; and 3) cellular lipoprivation induced by peripheral infusion of sodium mercaptoacetate (MA; 2.4 mg/kg·h alone or combined with 25 mg/kg·h of 2DG, iv), and effects on the interval of characteristic increases in MUA (MUA volleys) were examined. Infusion of the highest dose of 2DG increased the mean interval between MUA volleys, whereas the lower doses of 2DG had no effect on volley interval. The MUA volley intervals lengthened as insulin-induced hypoglycemia became profound. There was a negative correlation between MUA volley intervals and blood glucose concentrations during insulin infusion, and coinfusion of glucose with insulin returned the MUA volley interval to a normal frequency. Infusion of MA alone or MA with 2DG did not increase MUA volley intervals. These findings demonstrate that glucose availability, but not fatty acids, regulates the GnRH pulse generator activity in the ruminant. Glucose is considered a key metabolic regulator that fine-tunes pulsatile GnRH release.

Study of the Correlation between Tear Glucose Concentrations and Blood Glucose Concentrations

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 944-P
Author(s):  
MASAKAZU AIHARA ◽  
NAOTO KUBOTA ◽  
TAKASHI KADOWAKI
Keyword(s):  
Blood Glucose ◽  
Tear Glucose ◽  
Blood Glucose Concentrations
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