A model for multiple subcutaneous insulin injections developed from individual diabetic patient data

1995 ◽  
Vol 269 (6) ◽  
pp. E1115-E1124 ◽  
Author(s):  
W. R. Puckett ◽  
E. N. Lightfoot
Keyword(s):  
Management Strategies ◽  
Sensitivity Coefficient ◽  
Diabetic Patients ◽  
Model Parameters ◽  
Subcutaneous Insulin ◽  
Insulin Levels ◽  
Injection Effect ◽  
Frequent Sampling ◽  
And Control ◽  
Glucose Dynamics

Many diabetic patients taking multiple subcutaneous insulin injections cannot adjust their dosage appropriately to maintain blood glucose within a normal range. It is hard to predict how dosage changes and physiological fluctuations affect insulin levels and subsequently glucose control. To examine these issues, we have developed a model representing the link between dosage and blood insulin levels. Our model adequately predicts insulin concentrations for individual patients and could be incorporated into an overall glucose-insulin representation. More importantly, parameter and sensitivity analysis results highlight insulin kinetic features that are difficult to isolate in a clinical setting and that may significantly influence glucose dynamics. For example, large interpatient variation, measured quantitatively by model parameters, emphasizes the need for individualized design of insulin regimens. Intrapatient variations are also large in some patients. Improved control for these patients may only be possible through more frequent sampling and control action. The sensitivity coefficient for absorption suggests a significant overlapping injection effect that is not considered in present patient management strategies.

Tests for Platelet Changes, Acute Phase Reactants and Serum Lipids in Diabetes mellitus and Peripheral Vascular Disease

1982 ◽  
Vol 48 (03) ◽  
pp. 289-293 ◽  
Author(s):  
B A van Oost ◽  
B F E Veldhuyzen ◽  
H C van Houwelingen ◽  
A P M Timmermans ◽  
J J Sixma
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Acute Phase ◽  
Serum Lipids ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Acute Phase Reactants ◽  
Control Subjects ◽  
And Control

SummaryPlatelets tests, acute phase reactants and serum lipids were measured in patients with diabetes mellitus and patients with peripheral vascular disease. Patients frequently had abnormal platelet tests and significantly increased acute phase reactants and serum lipids, compared to young healthy control subjects. These differences were compared with multidiscriminant analysis. Patients could be separated in part from the control subjects with variables derived from the measurement of acute phase proteins and serum lipids. Platelet test results improved the separation between diabetics and control subjects, but not between patients with peripheral vascular disease and control subjects. Diabetic patients with severe retinopathy frequently had evidence of platelet activation. They also had increased acute phase reactants and serum lipids compared to diabetics with absent or nonproliferative retinopathy. In patients with peripheral vascular disease, only the fibrinogen concentration was related to the degree of vessel damage by arteriography.

Preferable Conversion Rate from Intravenous to Subcutaneous Insulin in Hyperglycemic Emergencies in Diabetic Patients

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2286-PUB
Author(s):  
HIKARU TAKAMINE ◽  
YULIA NAMIKI ◽  
HIROKO HIIRAGI ◽  
TAKU YAMADA ◽  
YUYA TAKANO ◽  
...  
Keyword(s):  
Conversion Rate ◽  
Diabetic Patients ◽  
Subcutaneous Insulin

Role of Inflammatory Markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment

2019 ◽  
Vol 15 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Salwa S. Hosny ◽  
Ahmed M. Bahaaeldin ◽  
Mohamed S. Khater ◽  
Meram M. Bekhet ◽  
Hayam A. Hebah ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Elderly Patients ◽  
Vascular Disease ◽  
Plasma Glucose ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Hs Crp ◽  
And Control

<P>Background: Type 2 diabetes (T2DM) is a risk factor for Alzheimer’s disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain but, chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated. </P><P> Objectives: To determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI). Methods: Our study was conducted on 90 elderly subjects (aged 60 years old or more). They were divided into Group І, 30 patients with T2DM and mild cognitive impairment, group ІІ, 30 patients with T2DM without cognitive impairment and group III, 30 healthy subjects as a control group. They were subjected to history taking, full clinical examination, anthropometric measurement, the Addenbrooke’s Cognitive Examination III (ACE---III 2012), Fasting plasma glucose, 2 hours plasma glucose, HbA1c, lipid profile, protein/creatinine ratio, serum sVCAM-1 and hs-CRP. Results: Serum levels of sVCAM-1 in diabetic elderly patients with MCI were significantly higher (946.7 ± 162.01 ng/ml) than diabetic elderly patients without cognitive impairment (479.06 ± 65.27 ng/ml) and control (263.7 ± 72.05 ng/ml) with (P=0.002). Serum levels of Hs-CRP in diabetic elderly patients with MCI were significantly higher than as diabetic elderly patients without cognitive impairment and control with (P=0.005). Conclusion: Elderly diabetic patients with mild cognitive impairment have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation than other groups.</P>

Update of the last 2 years on the impact of the internet and social networks on the management of type 2 diabetes mellitus: simple review. (Preprint)

2020 ◽  
Author(s):  
Mayli Lañas-Navarro ◽  
Jose Ipanaque-Calderon Sr ◽  
Fiorela E Solano
Keyword(s):  
Social Networks ◽  
Mobile Applications ◽  
Health Personnel ◽  
Online Courses ◽  
The Internet ◽  
Diabetic Patients ◽  
Bibliographic Search ◽  
Use Of The Internet ◽  
And Control ◽  
The Impact

BACKGROUND Research on the use of the Internet in the medical field is experiencing many advances, including mobile applications, social networks, telemedicine. Its implementation in medical care and comprehensive patient management is a much discussed topic at present. OBJECTIVE This narrative review aims to understand the impact of the internet and social networks on the management of diabetes, both for patients and medical staff. METHODS The bibliographic search was carried out in the databases Pubmed, Virtual Health Library (VHL) and Lilacs between 2018 to 2020. RESULTS Multiple mobile applications have been created for the help and control of diabetic patients, as well as the implementation of online courses, improving the knowledge of health personnel applying them in the field of telemedicine. CONCLUSIONS The use of the Internet and social networks brings many benefits for both the diabetic patient and the health personnel, offering advantages for both.

scholarly journals Intraperitoneal insulin administration in pigs: effect on circulating insulin and glucose levels

2021 ◽  
Vol 9 (1) ◽  
pp. e001929
Author(s):  
Ilze Dirnena-Fusini ◽  
Marte Kierulf Åm ◽  
Anders Lyngvi Fougner ◽  
Sven Magnus Carlsen ◽  
Sverre Christian Christiansen
Keyword(s):  
Systemic Circulation ◽  
Subcutaneous Insulin ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Endogenous Insulin ◽  
Blood Glucose Levels ◽  
Intraperitoneal Insulin ◽  
A Minor ◽  
Design And Methods ◽  
Mean Blood Glucose

IntroductionThe effect of intraperitoneal insulin infusion has limited evidence in the literature. Therefore, the aim of the study was to investigate the pharmacokinetics and pharmacodynamics of different intraperitoneal insulin boluses. There is a lack of studies comparing the insulin appearance in the systemic circulation after intraperitoneal compared with subcutaneous insulin delivery. Thus, we also aimed for a comparison with the subcutaneous route.Research design and methodsEight anesthetized, non-diabetic pigs were given three different intraperitoneal insulin boluses (2, 5 and 10 U). The order of boluses for the last six pigs was randomized. Endogenous insulin and glucagon release were suppressed by repeated somatostatin analog injections. The first pig was used to identify the infusion rate of glucose to maintain stable glucose values throughout the experiment. The estimated difference between insulin boluses was compared using two-way analysis of variance (GraphPad Prism V.8).In addition, a trial of three pigs which received subcutaneous insulin boluses was included for comparison with intraperitoneal insulin boluses.ResultsDecreased mean blood glucose levels were observed after 5 and 10 U intraperitoneal insulin boluses compared with the 2 U boluses. No changes in circulating insulin levels were observed after the 2 and 5 U intraperitoneal boluses, while increased circulating insulin levels were observed after the 10 U intraperitoneal boluses. Subcutaneously injected insulin resulted in higher values of circulating insulin compared with the corresponding intraperitoneal boluses.ConclusionsSmaller intraperitoneal boluses of insulin have an effect on circulating glucose levels without increasing insulin levels in the systemic circulation. By increasing the insulin bolus, a major increase in circulating insulin was observed, with a minor additive effect on circulating glucose levels. This is compatible with a close to 100% first-pass effect in the liver after smaller intraperitoneal boluses. Subcutaneous insulin boluses markedly increased circulating insulin levels.

scholarly journals Farmer Knowledge in Potato Virus Epidemiology and Control in Kenya

2020 ◽  
Author(s):  
John Onditi ◽  
Nancy Ng’anga ◽  
Moses Nyongesa ◽  
René van der Vlugt
Keyword(s):  
Potato Virus ◽  
Management Strategies ◽  
Technical Information ◽  
Household Survey ◽  
Farmer Knowledge ◽  
Policy Makers ◽  
Virus Control ◽  
Modes Of Transmission ◽  
Potato Yields ◽  
And Control

AbstractPotato is an important food security crop in Kenya. High prevalence of potato viruses is one of the major causes of low potato yields. Implementation of effective virus management strategies requires information on farmers’ perceptions and practices on virus epidemiology and control. To better understand farmers’ knowledge and practices in virus control and set possible pathways for intervention, a household survey involving 147 respondents was conducted in two major potato-growing regions in Kenya. Lack of sufficient technical information on potato virus symptoms, vectors and modes of transmission was found to be the major hindrance to farmers’ efforts towards virus control. A spider diagram approach was therefore used to determine the aspect of virus control that required the highest prioritization for immediate intervention by policy makers. Use of virus-resistant cultivars was found to require the most urgent attention compared to other aspects of virus control and was expected to have greater impact in lowering virus prevalence. This study showed that enhancing farmer knowledge needs to be prioritised as this is a key determinant of the success of the virus control strategy to be selected for implementation.

scholarly journals Occurrence, Impact on Agriculture, Human Health, and Management Strategies of Zearalenone in Food and Feed: A Review

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 92
Author(s):  
Dipendra Kumar Mahato ◽  
Sheetal Devi ◽  
Shikha Pandhi ◽  
Bharti Sharma ◽  
Kamlesh Kumar Maurya ◽  
...  
Keyword(s):  
Human Health ◽  
Control Strategies ◽  
Management Strategies ◽  
Structural Similarity ◽  
Fungal Metabolites ◽  
Natural Estrogens ◽  
Food And Feed ◽  
Feed Safety ◽  
And Control ◽  
Different Sources

Mycotoxins represent an assorted range of secondary fungal metabolites that extensively occur in numerous food and feed ingredients at any stage during pre- and post-harvest conditions. Zearalenone (ZEN), a mycotoxin categorized as a xenoestrogen poses structural similarity with natural estrogens that enables its binding to the estrogen receptors leading to hormonal misbalance and numerous reproductive diseases. ZEN is mainly found in crops belonging to temperate regions, primarily in maize and other cereal crops that form an important part of various food and feed. Because of the significant adverse effects of ZEN on both human and animal, there is an alarming need for effective detection, mitigation, and management strategies to assure food and feed safety and security. The present review tends to provide an updated overview of the different sources, occurrence and biosynthetic mechanisms of ZEN in various food and feed. It also provides insight to its harmful effects on human health and agriculture along with its effective detection, management, and control strategies.

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