Effects of exercise on insulin-induced hypoglycemia

1990 ◽  
Vol 69 (2) ◽  
pp. 686-693 ◽  
Author(s):  
J. Arogyasami ◽  
R. K. Conlee ◽  
C. L. Booth ◽  
R. Diaz ◽  
T. Gregory ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Time Course ◽  
Insulin Infusion ◽  
Progressive Decline ◽  
Rate Of Development ◽  
Significant Difference ◽  
Ad Libitum ◽  
Rate Of Decline

The purpose of this study was to determine the effect of exercise on the rate of onset of hypoglycemia induced by infusion of excess insulin (0.8 mU.min-1.100 g-1). Rats were either fasted overnight (FS) or fed ad libitum (FD). FS rats were killed after 5, 10, or 15 min of infusion at rest or after running on the treadmill at 21 m/min and 15% grade. FD rats were killed after 10, 20, or 40 min of infusion at rest or after exercise. Rats were also killed 15 min postexercise for FS and 60 or 120 min postexercise for FD with continued insulin infusion. The progressive decline in blood glucose was not altered by exercise in the FS rats. FD rats showed a significant difference due to exercise only after 40 min (rest 4.2 +/- 0.3 mM, exercise 3.2 +/- 0.2 mM). A significant postexercise repletion of glycogen was observed in red vastus and soleus muscles of FD rats despite the decreasing blood glucose values. These data indicate that exercise accelerates the rate of development of hypoglycemia in FD rats. In the FS rats, where the rate of decline in blood glucose was greater, exercise had no effect on the time course of development of hypoglycemia.

Liver fructose 2,6-bisphosphate in rats running at different treadmill speeds

1988 ◽  
Vol 255 (1) ◽  
pp. R38-R41
Author(s):  
W. W. Winder ◽  
H. T. Yang ◽  
J. Arogyasami
Keyword(s):  
Blood Glucose ◽  
Time Course ◽  
Liver Glycogen ◽  
Work Rate ◽  
Rapid Decline ◽  
Cyclic Monophosphate ◽  
Significant Change ◽  
Rate Of Decline ◽  
All Speeds

To determine the effect of work rate on liver fructose 2,6-bisphosphate (fructose 2,6-P2), rats were run for 5 min on a treadmill up a 15% grade at 16, 21, 26, 31, and 36 m/min. The liver content of fructose 2,6-P2 decreased 25, 42, 50, 62, and 71% from resting values after 5 min of running at these work rates. The time course of the decline in liver fructose 2,6-P2 was also studied in rats run at 16 m/min for times ranging from 5 to 100 min, at 23 m/min for times ranging from 5 to 60 min, and at 31 m/min for times of 5, 10, and 20 min. The hepatic content of fructose 2,6-P2 declined significantly after 5 min in all three groups of rats. The rate of decline was greatest in rats run at 31 m/min. After 100 min of running, fructose 2,6-P2 in livers of rats running at 16 m/min declined to levels seen in rats run at 31 m/min for 20 min. Changes in fructose 2,6-P2 occurred before a detectable decline in liver glycogen and in the absence of any significant change in blood glucose. Liver adenosine 3',5'-cyclic monophosphate (cAMP) was elevated after 5 min of exercise in rats running at 23 and 31 m/min but not in rats running at 16 m/min. By the end of exercise, hepatic cAMP was elevated in rats running at all speeds. The rapid decline in fructose 2,6-P2 probably plays a role in decreasing hepatic glycolysis, thereby ensuring that glucose 6-phosphate derived from glycogenolysis is diverted to blood glucose.

Conversion from Continuous Insulin Infusions to Subcutaneous Insulin in Critically III Patients

2009 ◽  
Vol 43 (4) ◽  
pp. 629-634 ◽  
Author(s):  
Kyle A Weant ◽  
Alim Ladha
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Insulin Requirement ◽  
Study Data ◽  
Target Range ◽  
Subcutaneous Insulin ◽  
Subcutaneous Dose ◽  
Target Values ◽  
Significant Difference ◽  
History Of

Background: Continuous insulin infusions have become a standard of care in many intensive care units (ICUs); however, methods for transitioning patients from continuous infusions to other insulin therapies have not been extensively evaluated. Objective: To determine the most effective method for transitioning ICU patients from continuous insulin infusions to subcutaneous insulin therapy. Methods: A searchable pharmacy database at the University of North Carolina Hospitals was used to retrospectively identify adults admitted to the neurosurgery ICU and prescribed a continuous insulin infusion between May 2007 and February 2008, All patients were transitioned to subcutaneous insulin upon floor transfer. Patients were stratified according to the dose of subcutaneous insulin as a percentage of their prior 24-hour continuous insulin requirement and then analyzed on the rate of achievement of goal blood glucose values (80–150 mg/dL) within the first 48 hours after transition. Results: A total of 769 blood glucose values from 79 patients were recorded during the study. Data analysis demonstrated significantly lower median blood glucose values with the use of subcutaneous insulin doses that were 60–70% of insulin infusion requirements when compared with all other groups. For patients without a history of diabetes mellitus, the use of a subcutaneous dose that was 60–70% of the insulin infusion requirement resulted in a significantly greater percentage of patients within the target range compared with other groups (78%; p < 0.05). For those with a history of diabetes, subcutaneous doses higher than 70% of the insulin infusion requirement yielded the most frequent achievement of target values, although there was substantial variability within this group. No significant difference was noted in the incidence of hypoglycemia (blood glucose <80 mg/dL) between groups, although the frequency of hypoglycemia was almost twice as high in the group with diabetes as in those without it (4.2% vs 2.2%). Conclusions: Methods currently used to transition patients off insulin infusions vary widely. Initial data suggest that utilizing 60–70% of the 24-hour insulin infusion requirement as a subcutaneous dose would result in blood glucose values of 80–150 mg/dL 70% of the time. Further study is necessary to adequately assess the optimal insulin infusion transition protocol for critically ill patients to ensure both safety and efficacy.

Intake and digestibility by sheep of artificially dried forages in several physical forms

1972 ◽  
Vol 78 (1) ◽  
pp. 79-86 ◽  
Author(s):  
J. A. Milne ◽  
R. C. Campling
Keyword(s):  
Particle Size ◽  
Italian Ryegrass ◽  
Crude Fibre ◽  
Wide Range ◽  
Significant Difference ◽  
Ad Libitum ◽  
Voluntary Intake ◽  
Rate Of Decline ◽  
Fourth Experiment ◽  
Male Sheep

SUMMARYIn three experiments high quality, autumn-harvested dried Italian ryegrass and lucerne in the form of cobs and pellets and in one of these experiments in the chopped form were offered to mature castrated male sheep at a maintenance level of feeding. Only small differences were found between the physical forms of forage in digestibility of organic matter, retention of nitrogen and loss of energy in the urine, but the digestibility of crude fibre and the mean retention time of stained feed in the gut decreased with decreasing particle size. Increasing the level of feeding of cobs and of pellets from 800 g daily by three equal increments of 400 g caused a linear decline in digestibility but no difference was found between cobs and pellets in the rate of decline of digestibility. In three experiments the dried forages were offered ad libitum and in a fourth experiment a wide range of particle size was simulated by offering ad libitum five ratios of chopped and pelleted grass. Voluntary intake tended to increase as the particle size was reduced over the whole range, but there was no significant difference between the voluntary intakes of mixtures with a modulus of fineness of 4·4 or less. No difference was detected between the voluntary intake of cobs and pellets.

Effect of fasting on glucose turnover in a carnivorous fish (Hoplias sp)

1989 ◽  
Vol 256 (3) ◽  
pp. R612-R615 ◽  
Author(s):  
C. R. Machado ◽  
M. A. Garofalo ◽  
J. E. Roselino ◽  
I. C. Kettelhut ◽  
R. H. Migliorini
Keyword(s):  
Blood Glucose ◽  
Specific Radioactivity ◽  
Glucose Turnover ◽  
Intravenous Glucose ◽  
Progressive Decline ◽  
Tests And Measurements ◽  
Concomitant Reduction ◽  
Glucose Tolerance Tests ◽  
Rate Of Decline ◽  
Intravenous Glucose Tolerance Tests

Intravenous glucose tolerance tests and measurements with [6-3H]glucose of rate of glucose replacement, transit time, and body glucose mass were performed in fed and fasted Hoplias malabaricus. Both glycemia levels and the rate of decline of blood glucose following intravenous administration of 500 mg/kg glucose were significantly lower in 60-day-fasted than in fed fish. Changes in plasma free fatty acids were opposite to those in blood glucose. The rate of glucose replacement, calculated graphically from mean +/- 3 SE plots of glucose specific radioactivity, was 0.71 (0.66-0.77) mg.kg-1.min-1 in fed H. malabaricus and decreased to 0.51 (0.46-0.56) mg.kg-1.min-1 after 60 days without food, with a concomitant reduction of body glucose mass (mmin, 138 vs. 83 mg/kg). In fish starved for 10 mo the rate of glucose replacement and body glucose mass were further reduced to 0.35 (0.29-0.42) mg.kg-1.min-1 and 57 mg/kg (mmin), respectively. It is concluded that a progressive decline in the rate of glucose utilization contributes to the adaptation of fish to prolonged fasting.

Conventional approach to glucose management for diabetic patients undergoing coronary artery bypass surgery

Perfusion ◽  
2002 ◽  
Vol 17 (2) ◽  
pp. 141-144 ◽  
Author(s):  
Patricia A Gustafson ◽  
Debra L Zarro ◽  
David A Palanzo ◽  
Norman J Manley ◽  
Ralph M Montesano ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Diabetic Patients ◽  
Type I ◽  
Cardioplegic Solution ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Continuous insulin infusion was not an effective mode of treatment in maintaining safe blood glucose levels (<200 mg/dl) during the intraoperative period of diabetic patients requiring open-heart surgery. The two modifications investigated to gain better control of the blood glucose were a change in the base solution of the cardioplegia and the use of a sliding insulin scale. Fifty patients including Type I and Type II diabetics were selected for the purpose of this study. The patients were then randomly divided into two groups categorized by the type of cardioplegic solution administered and the mode of insulin treatment. Group I patients received a dextrose 5%-based cardioplegic solution and blood glucose was treated via continuous intravenous insulin infusion. Group II patients received normal saline 0.9%-based cardioplegic solution and blood glucose was treated via sliding scale. Blood glucose levels were monitored pre- and postcardio- pulmonary bypass (CPB) and every 30 min while on CPB. Glucose values were analyzed by group t test. A p value of < 0.05 was considered statistically significant. When comparing Group I (mean=258 mg/dl) with Group II (mean= 158 mg/dl), there was a statistically significant difference between the glucose values at each of the time intervals when the glucose values were recorded. In conclusion, Group II maintained an acceptable blood glucose level (<200 mg/dl) throughout the entire intra- operative period, which suggests that the combination of the sliding insulin scale and modification of the base cardioplegic solution was an effective mode of treatment.

scholarly journals Comparison of Two Intravenous Insulin Titration Methods in Hyperglycemic Crisis

2017 ◽  
Vol 33 (2) ◽  
pp. 72-77
Author(s):  
Eileen F. Rohrbach ◽  
Kellianne Webb ◽  
Tracy Costello
Keyword(s):  
Blood Glucose ◽  
Insulin Infusion ◽  
Retrospective Chart Review ◽  
Primary Efficacy ◽  
Fixed Rate ◽  
Titration Method ◽  
Safety Outcome ◽  
Intravenous Insulin ◽  
Significant Difference ◽  
Mean Time

Background: Glycemic control using intravenous insulin infusions is an important component of hyperglycemic crisis treatment. Literature supports the use of standardized titration protocols; however, comparisons of specific methods are limited. Objective: Compare the safety and efficacy of 2 insulin infusion titration methods used in hyperglycemic crisis. Methods: A retrospective chart review was conducted including adults admitted to an inpatient facility from August 1, 2013, to August 1, 2015, who were treated for at least 4 hours with an intravenous insulin infusion. Primary efficacy outcomes of time to anion gap closure and time to goal blood glucose was studied in patients meeting criteria for diabetic ketoacidosis (n = 79), while the primary safety outcome of rates of hypoglycemia were compared among all study patients (n = 200). Results: The fixed-rate titration method had statistically shorter time to blood glucose <200 mg/dL compared to the multiplier titration group (6.1 [4.0] vs 8.8 [4.4], respectively; P = .018; mean time in hours [standard deviation]); however, no statistically significant difference was seen in the other primary efficacy and safety outcomes. Statistical improvements were found in secondary outcomes of intensive/progressive care units, length of stay, and infusion duration in the fixed-rate titration method, while less deviation from titration recommendations was found in the multiplier titration group. Conclusions: Significant differences seen in time to a goal blood glucose, deviation prevalence, and holds of the infusion for low blood glucose have identified areas for optimization, additional study, and staff education.

Time Course of Simulator Sickness in Asian Military Pilots

2020 ◽  
Vol 91 (11) ◽  
pp. 892-896
Author(s):  
Janine En Qi Loi ◽  
Magdalene Li Ling Lee ◽  
Benjamin Boon Chuan Tan ◽  
Brian See
Keyword(s):  
Air Force ◽  
Time Course ◽  
Simulator Training ◽  
Simulator Sickness ◽  
Time Points ◽  
True Prevalence ◽  
Subjective Scale ◽  
Significant Difference ◽  
Simulator Sickness Questionnaire ◽  
Military Pilots

INTRODUCTION: This study sought to determine the incidence, severity, and time-course of simulator sickness (SS) among Asian military pilots following flight simulator training.METHODS: A survey was conducted on Republic of Singapore Air Force pilots undergoing simulator training. Each subject completed a questionnaire immediately after (0H), and at the 3-h (3H) and 6-h (6H) marks. The questionnaire included the simulator sickness questionnaire (SSQ) and a subjective scale to rate their confidence to fly.RESULTS: In this study, 258 pilots with a median age of 31.50 yr (range, 2155 yr) and mean age of 32.61 6.56 yr participated. The prevalence of SS was 48.1% at 0H, 30.8% at 3H, and 16.4% at 6H. Based on a threshold of an SSQ score >10, the prevalence of operationally significant SS was 33.3% at 0H, 13.2% at 3H, and 8.1% at 6H. The most frequent symptoms were fatigue (38.1%), eye strain (29.0%), and fullness of head (19.9%). There was no significant difference in mean scores between rotary and fixed wing pilots. Older, more experienced pilots had greater scores at 0H, but this association did not persist. A correlation was found between SSQ score and self-reported confidence.DISCUSSION: To our knowledge, this study is the first to report the prevalence of operationally significant SS in Asian military pilots over serial time points. Most pilots with SS are able to subjectively judge their fitness to fly. Sensitivity analysis suggests the true prevalence of SS symptoms at 3H and 6H to be closer to 23.8% and 12.0%, respectively.Loi JEQ, Lee MLL, Tan BBC, See B. Time course of simulator sickness in Asian military pilots. Aerosp Med Hum Perform. 2020; 91(11):892896.

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

scholarly journals Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yonghuan Bian ◽  
Changhao Liu ◽  
Zhaojiang Fu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Chronic Periodontitis ◽  
Root Planing ◽  
Tnf Α ◽  
Significant Difference ◽  
Hs Crp

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.

scholarly journals Outcome of the use of 0.9% saline versus 0.45% saline for fluid rehydration in moderate and severe diabetic ketoacidosis in children

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Nora El Said Badawi ◽  
Mona Hafez ◽  
Heba Sharaf Eldin ◽  
Hend Mehawed Abdelatif ◽  
Shimaa Atef ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Diabetic Ketoacidosis ◽  
Normal Saline ◽  
Sodium Concentration ◽  
Saline Group ◽  
Serum Electrolytes ◽  
Serum Chloride ◽  
Significant Difference ◽  
Rehydration Solution ◽  
The Moment

Abstract Background The debate for the optimum sodium concentration in the rehydration solution in diabetic ketoacidosis (DKA) persists till the moment. The aim was to compare the outcome of 0.9% saline versus 0.45% saline in children with moderate and severe (DKA) regarding the effect on serum electrolytes, duration of DKA resolution and the incidence of hyperchloremia. Results A retrospective analysis of 121 children with moderate or severe DKA was done. After the initial 4 h in which both groups received normal saline, patients were divided into two groups continuing on 0.9% (N=72) or switched to 0.45% saline (N=49). Serum chloride and Cl/Na ratios were significantly higher in 0.9% saline group at 4 and 8 h. The 0.9% saline group had significantly higher proportion of hyperchloremia at 4 and 8 h (P value: 0.002, 0.02). The median duration of correction of DKA (14 h among 0.9% saline versus 10 h among 0.45% saline) without significant difference (P value= 0.43). The change in plasma glucose, effective osmolarity, corrected Na levels were comparable between groups. Conclusion There is an unavoidable iatrogenically induced rise in serum chloride with higher incidence of hyperchloremia with the use of normal saline in rehydration of children presenting in DKA and shock. The use of 0.45% saline as post-bolus rehydration fluid is not associated with a decline in the corrected serum sodium concentration and does not affect the rate of correction of acidosis or rate of drop in blood glucose or duration of DKA resolution when compared to normal saline.

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