scholarly journals Calculating the Mean Amplitude of Glycemic Excursions from Continuous Glucose Data Using an Open-Code Programmable Algorithm Based on the Integer Nonlinear Method

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Xuefei Yu ◽  
Liangzhuo Lin ◽  
Jie Shen ◽  
Zhi Chen ◽  
Jun Jian ◽  
...  
Keyword(s):  
Glycemic Variability ◽  
Mean Amplitude ◽  
Nonlinear Method ◽  
Manual Method ◽  
Mathematical Algorithm ◽  
Software Products ◽  
Huge Data ◽  
The Mean ◽  
Open Code ◽  
Manual Calculation

The mean amplitude of glycemic excursions (MAGE) is an essential index for glycemic variability assessment, which is treated as a key reference for blood glucose controlling at clinic. However, the traditional “ruler and pencil” manual method for the calculation of MAGE is time-consuming and prone to error due to the huge data size, making the development of robust computer-aided program an urgent requirement. Although several software products are available instead of manual calculation, poor agreement among them is reported. Therefore, more studies are required in this field. In this paper, we developed a mathematical algorithm based on integer nonlinear programming. Following the proposed mathematical method, an open-code computer program named MAGECAA v1.0 was developed and validated. The results of the statistical analysis indicated that the developed program was robust compared to the manual method. The agreement among the developed program and currently available popular software is satisfied, indicating that the worry about the disagreement among different software products is not necessary. The open-code programmable algorithm is an extra resource for those peers who are interested in the related study on methodology in the future.

scholarly journals Glycemic Variability Impacted by SGLT2 Inhibitors and GLP 1 Agonists in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (18) ◽  
pp. 4078
Author(s):  
Heeyoung Lee ◽  
Se-eun Park ◽  
Eun-Young Kim
Keyword(s):  
Meta Analysis ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Randomized Controlled ◽  
Sodium Glucose Cotransporter ◽  
Patients With Diabetes ◽  
The Mean ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Mean Blood Glucose

To investigate the effect of sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) agonists on glycemic variability (GV), the mean amplitude of glucose excursion (MAGE), mean blood glucose (MBG) levels, and percentage of time maintaining euglycemia were evaluated. Randomized controlled trials evaluating the efficacy of SGLT-2 inhibitors and GLP-1 agonists for treating people with diabetes were selected through searches of PubMed, EMBASE, and other databases. Sixteen studies were finally analyzed. There were no differences in the reductions in MAGE after treatment with SGLT-2 inhibitors or GLP-1 agonists (standardized mean difference (SMD) = −0.59, 95% CI = −0.82 to −0.36 vs. SMD = −0.43, 95% CI = −0.51 to −0.35, respectively), and treatment with SGLT-2 inhibitors was associated with an increased reduction in MBG levels (SMD = −0.56, 95% CI = −0.65 to −0.48, p < 0.00001). Monotherapy and add-on therapy with medications were correlated with MAGE and MBG level reductions. In conclusion, SGLT-2 inhibitors and GLP-1 agonists were associated with a reduction in GV and could be alternatives for treating people with diabetes.

scholarly journals CGMS and Glycemic Variability, Relevance in Clinical Research to Evaluate Interventions in T2D, a Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Anne-Esther Breyton ◽  
Stéphanie Lambert-Porcheron ◽  
Martine Laville ◽  
Sophie Vinoy ◽  
Julie-Anne Nazare
Keyword(s):  
Physical Activity ◽  
Glycemic Control ◽  
Glucose Control ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Control Parameters ◽  
Postprandial Glycemia ◽  
The Mean ◽  
Mean Blood Glucose

Glycemic variability (GV) appears today as an integral component of glucose homeostasis for the management of type 2 diabetes (T2D). This review aims at investigating the use and relevance of GV parameters in interventional and observational studies for glucose control management in T2D. It will first focus on the relationships between GV parameters measured by continuous glucose monitoring system (CGMS) and glycemic control and T2D-associated complications markers. The second part will be dedicated to the analysis of GV parameters from CGMS as outcomes in interventional studies (pharmacological, nutritional, physical activity) aimed at improving glycemic control in patients with T2D. From 243 articles first identified, 63 articles were included (27 for the first part and 38 for the second part). For both analyses, the majority of the identified studies were pharmacological. Lifestyle studies (including nutritional and physical activity-based studies, N-AP) were poorly represented. Concerning the relationships of GV parameters with those for glycemic control and T2D related-complications, the standard deviation (SD), the coefficient of variation (CV), the mean blood glucose (MBG), and the mean amplitude of the glycemic excursions (MAGEs) were the most studied, showing strong relationships, in particular with HbA1c. Regarding the use and relevance of GV as an outcome in interventional studies, in pharmacological ones, SD, MAGE, MBG, and time in range (TIR) were the GV parameters used as main criteria in most studies, showing significant improvement after intervention, in parallel or not with glycemic control parameters’ (HbA1c, FBG, and PPBG) improvement. In N-AP studies, the same results were observed for SD, MAGE, and TIR. Despite the small number of N-AP studies addressing both GV and glycemic control parameters compared to pharmacological ones, N-AP studies have shown promising results on GV parameters and would require more in-depth work. Evaluating CGMS-GV parameters as outcomes in interventional studies may provide a more integrative dimension of glucose control than the standard postprandial follow-up. GV appears to be a key component of T2D dysglycemia, and some parameters such as MAGE, SD, or TIR could be used routinely in addition to classical markers of glycemic control such as HbA1c, fasting, or postprandial glycemia.

scholarly journals Lower Interstitial Glucose Concentrations but Higher Glucose Variability during Low-Energy Diet Compared to Regular Diet—An Observational Study in Females with Obesity

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3687
Author(s):  
Inger Nilsen ◽  
Agneta Andersson ◽  
Anna Laurenius ◽  
Johanna Osterberg ◽  
Magnus Sundbom ◽  
...  
Keyword(s):  
Observational Study ◽  
Dietary Intake ◽  
Area Under The Curve ◽  
Glycemic Variability ◽  
Mean Amplitude ◽  
Low Energy ◽  
Regular Diet ◽  
Interstitial Glucose ◽  
The Mean ◽  
Low Energy Diet

This is an observational study of interstitial glucose (IG) concentrations, IG variability and dietary intake under free-living conditions in 46 females with obesity but without diabetes. We used continuous glucose monitoring, open-ended food recording and step monitoring during regular dietary intake followed by a low-energy diet (LED). Thirty-nine participants completed both study periods. The mean BMI at baseline was 43.6 ± 6.2 kg/m2. Three weeks of LED resulted in a mean weight loss of 5.2% with a significant reduction in diurnal IG concentration but with greater glycemic variability observed during LED. The mean 24 h IG concentration decreased from 5.8 ± 0.5 mmol/L during the regular diet period to 5.4 ± 0.5 mmol/L (p < 0.001) during LED, while the mean amplitude of glycemic excursion increased from 1.5 ± 0.7 to 1.7 ± 0.7 mmol/L (p = 0.031). The positive incremental area under the curve at breakfast was significantly larger for LED compared to regular diet. The daily fiber intake and the glycemic index of breakfast meals were significantly associated with the glycemic variability during regular dietary intake. In conclusion, the 24 h mean IG concentration was lower but with more pronounced glycemic variability during LED compared to a regular diet.

Quantitative analysis of static equilibrium in women after mastectomy

2014 ◽  
Vol 14 (1) ◽  
pp. 81-87
Author(s):  
Maciej Rachwał ◽  
Justyna Drzał-Grabiec ◽  
Katarzyna Walicka-Cupryś ◽  
Aleksandra Truszczyńska
Keyword(s):  
Mean Amplitude ◽  
Control Group ◽  
Foot Pressure ◽  
Locomotor System ◽  
Center Of Foot Pressure ◽  
The Mean ◽  
Almost All ◽  
Posture Stability ◽  
Mastectomy Group ◽  
Better Than

Abstract Background: The post-mastectomy changes to the locomotor system are related to the scar and adhesion or to the lymphatic edema after amputation which, in turn, lead to local and global distraction of the work of the muscles. These changes lead to body statics disturbance that changes the projection of the center of gravity and worsens motor response due to changing of the muscle sensitivity. Objective: The aim of the study was to evaluate the static balance of women after undergoing mastectomy. Methods: The study included 150 women, including 75 who underwent mastectomy (mean age: 60±7.6) years, mean body mass index (BMI): 26 (±3.6) kg/m2) and 75 who were placed in the control group with matched age and BMI. The study was conducted using a tensometric platform. Results: Statistically significant differences were found for almost all parameters between the post-mastectomy group and group of healthy women, regarding center of foot pressure (COP) path length in the Y and X axes and the mean amplitude of COP. Conclusions: First, the findings revealed that balance in post-mastectomy women is significantly better than in the control group. Second, physiotherapeutic treatment of post-mastectomy women may have improved their posture stability compared with their peers.

Growth of fingers at an unstable diffusing interface in a porous medium or Hele-Shaw cell

1969 ◽  
Vol 39 (3) ◽  
pp. 477-495 ◽  
Author(s):  
R. A. Wooding
Keyword(s):  
Porous Medium ◽  
Numerical Solutions ◽  
Hyperbolic Equations ◽  
Saturated Porous Medium ◽  
Mean Amplitude ◽  
Wave Number ◽  
Two Fluids ◽  
Averaged Equations ◽  
The Mean ◽  
Hele Shaw Cell

Waves at an unstable horizontal interface between two fluids moving vertically through a saturated porous medium are observed to grow rapidly to become fingers (i.e. the amplitude greatly exceeds the wavelength). For a diffusing interface, in experiments using a Hele-Shaw cell, the mean amplitude taken over many fingers grows approximately as (time)2, followed by a transition to a growth proportional to time. Correspondingly, the mean wave-number decreases approximately as (time)−½. Because of the rapid increase in amplitude, longitudinal dispersion ultimately becomes negligible relative to wave growth. To represent the observed quantities at large time, the transport equation is suitably weighted and averaged over the horizontal plane. Hyperbolic equations result, and the ascending and descending zones containing the fronts of the fingers are replaced by discontinuities. These averaged equations form an unclosed set, but closure is achieved by assuming a law for the mean wave-number based on similarity. It is found that the mean amplitude is fairly insensitive to changes in wave-number. Numerical solutions of the averaged equations give more detailed information about the growth behaviour, in excellent agreement with the similarity results and with the Hele-Shaw experiments.

Twenty-four-hour rhythms of plasma glucose and insulin secretion rate in regular night workers

2000 ◽  
Vol 278 (3) ◽  
pp. E413-E420 ◽  
Author(s):  
C. Simon ◽  
L. Weibel ◽  
G. Brandenberger
Keyword(s):  
Insulin Secretion ◽  
Mean Amplitude ◽  
Sampling Procedure ◽  
Time Of Day ◽  
Secretion Rate ◽  
Nocturnal Sleep ◽  
Sleep Condition ◽  
The Mean ◽  
Nighttime Sleep ◽  
Insulin Secretion Rate

To determine whether the ultradian and circadian rhythms of glucose and insulin secretion rate (ISR) are adapted to their permanent nocturnal schedule, eight night workers were studied during their usual 24-h cycle with continuous enteral nutrition and a 10-min blood sampling procedure and were compared with 8 day-active subjects studied once with nocturnal sleep and once with an acute 8-h-shifted sleep. The mean 24-h glucose and ISR levels were similar in the three experiments. The duration and the number of the ultradian oscillations were influenced neither by the time of day nor by the sleep condition or its shift, but their mean amplitude increased during sleep whenever it occurred. In day-active subjects, glucose and ISR levels were high during nighttime sleep and then decreased to a minimum in the afternoon. After the acute sleep shift, the glucose and ISR rhythms were split in a biphasic pattern with a slight increase during the night of deprivation and another during daytime sleep. In night workers, the glucose and ISR peak levels exhibited an 8-h shift in accordance with the sleep shift, but the onset of the glucose rise underwent a shift of only 6 h and the sleep-related amplification of the glucose and ISR oscillations did not occur simultaneously. These results demonstrate that despite a predominant influence of sleep, the 24-h glucose and ISR rhythms are only partially adapted in permanent night workers.

Properties of Unitary IPSCs in Hippocampal Pyramidal Cells Originating From Different Types of Interneurons in Young Rats

1997 ◽  
Vol 77 (4) ◽  
pp. 1939-1949 ◽  
Author(s):  
Mohamed Ouardouz ◽  
Jean-Claude Lacaille
Keyword(s):  
Reversal Potential ◽  
Pyramidal Cells ◽  
Mean Amplitude ◽  
Paired Pulse ◽  
Young Rats ◽  
Different Types ◽  
The Mean ◽  
Paired Pulse Depression ◽  
Types Of Interneurons ◽  
Stimulation Of

Ouardouz, Mohamed and Jean-Claude Lacaille. Properties of unitary IPSCs in hippocampal pyramidal cells originating from different types of interneurons in young rats. J. Neurophysiol. 77: 1939–1949, 1997. Whole cell recordings were used in hippocampal slices of young rats to examine unitary inhibitory postsynaptic currents (uIPSCs) evoked in CA1 pyramidal cells at room temperature. Loose cell-attached stimulation was applied to activate single interneurons of different subtypes located in stratum oriens (OR), near stratum pyramidale (PYR), and at the border of stratum radiatum and lacunosum-moleculare (LM). uIPSCs evoked by stimulation of PYR and OR interneurons had similar onset latency, rise time, peak amplitude, and decay. In contrast, uIPSCs elicited by activation of LM interneurons were significantly smaller in amplitude and had a slower time course. The mean reversal potential of uIPSCs was −53.1 ± 2.1 (SE) mV during recordings with intracellular solution containing potassium gluconate. With the use of recording solution containing the potassium channel blocker cesium, the reversal potential of uIPSCs was not significantly different (−58.5 ± 2.6 mV), suggesting that these synaptic currents were not mediated by potassium conductances. Bath application of the γ-aminobutyric acid-A (GABAA) receptor antagonist bicuculline (25 μM) reversibly blocked uIPSCs evoked by stimulation of all interneuron subtypes. In bicuculline, the mean peak amplitude of uIPSCs recorded with potassium gluconate was reduced to 3.5 ± 4.4% of control ( n = 7). Similarly, with cesium methanesulfonate, the mean amplitude in bicuculline was 2.9 ± 3.1% of control ( n = 13). Application of the GABAB receptor antagonist CGP 55845A (5 μM) resulted in a significant and reversible increase in the mean amplitude of uIPSCs recorded with cesium-containing intracellular solution. Thus uIPSCs from all cell types appeared under tonic presynaptic inhibition by GABAB receptors. Paired stimulation of individual interneurons at 100- to 200-ms intervals did not result in paired pulse depression of uIPSCs. For individual responses, a significant negative correlation was observed between the amplitude of the first and second uIPSCs. A significant paired pulse facilitation (154.0 ± 8.0%) was observed when the first uIPSC was smaller than the mean of all first uIPSCs. A small, but not significant, paired pulse depression (90.8 ± 4.0%) was found when the first uIPSC was larger than the mean of all first uIPSCs. Our results indicate that these different subtypes of hippocampal interneurons generate Cl−-mediated GABAA uIPSCs. uIPSCs originating from different types of interneurons may have heterogeneous properties and may be subject to tonic presynaptic inhibition via heterosynaptic GABAB receptors. These results suggest a specialization of function for inhibitory interneurons and point to complex presynaptic modulation of interneuron function.

Eye Movements Simultaneously Recorded by Electrooculographic and Photoelectric Methods

1979 ◽  
Vol 48 (2) ◽  
pp. 619-624 ◽  
Author(s):  
Jin Ong ◽  
Gene A. Harman
Keyword(s):  
Eye Movements ◽  
Standard Deviation ◽  
Mean Amplitude ◽  
Mean Deviation ◽  
Deviation Index ◽  
Velocity Peak ◽  
The Mean

Three types of eye movements, saccadic, reading, and pursuit, were recorded from 6 college subjects, two in each by the electrooculographic and photoelectric methods simultaneously. A deviation index (DI), which is the standard deviation divided by the mean, was devised to compare the precision of recording amplitude deflection, and a proportion index (PI), which is M1 divided by M2, was devised to compare the mean amplitude indirectly between these two methods. Results showed that the proportion indexes of three types of eye movements were comparable, and the mean index of 0.54 indicated that the amplification in the electrooculographic method was about half as much as that in the photoelectric. The mean deviation index of 0.132 vs 0.135 was, again, comparable, meaning that these two methods of recording amplitude deflections are of about the same degree of magnitude and precision. Certain qualitative differences regarding the amplitude and velocity peak deflection between these two methods were also noted.

Influences of the Compliances and the Resistance on Pulsatile Flow Waveforms

2013 ◽  
Vol 477-478 ◽  
pp. 217-220
Author(s):  
Wen Bo He ◽  
Yuan Wang ◽  
Xiao Yan Gong
Keyword(s):  
Blood Circulation ◽  
Mean Amplitude ◽  
Circulation System ◽  
Aortic Blood Flow ◽  
Blood Circulation System ◽  
Aortic Blood ◽  
Pulsatile Pressure ◽  
The Mean ◽  
Flow Waveforms ◽  
Peak Value

A pulsatile circulation system has been built to simulate aortic blood flow. The system has both upstream and downstream compliances and resistances to simulate the elasticity and resistances of blood circulation system. Influences of the compliances and resistances on the pulsatile pressure waveforms have been systematically studied using this system. We found that in absence of the compliances and the downstream resistance, it results in an oversize negative pulsation to the pressure waveforms. The downstream resistance hardly affects the structure of the pressure waveforms, whereas the mean amplitude of pressure increases along with the downstream resistance. The compliance can reduce the peak value of the pressure, which is unrelated to the location of the compliance but related to the elasticity in the system. With fixed upstream system elasticity, the pressure waveform is more stable.

scholarly journals Low-Frequency Oscillations (<0.3 Hz) in the Electromyographic (EMG) Activity of the Human Trapezius Muscle During Sleep

2002 ◽  
Vol 88 (3) ◽  
pp. 1177-1184 ◽  
Author(s):  
R. H. Westgaard ◽  
P. Bonato ◽  
K. A. Holte
Keyword(s):  
Heart Rate ◽  
Muscle Activity ◽  
Activity Pattern ◽  
Sudden Change ◽  
Mean Amplitude ◽  
Activity Level ◽  
Emg Activity ◽  
Similar Frequency ◽  
Emg Signal ◽  
The Mean

The surface electromyographic (EMG) signal from right and left trapezius muscles and the heart rate were recorded over 24 h in 27 healthy female subjects. The root-mean-square (RMS) value of the surface EMG signals and the heartbeat interval time series were calculated with a time resolution of 0.2 s. The EMG activity during sleep showed long periods with stable mean amplitude, modulated by rhythmic components in the frequency range 0.05–0.2 Hz. The ratio between the amplitude of the oscillatory components and the mean amplitude of the EMG signal was approximately constant over the range within which the phenomenon was observed, corresponding to a peak-to-peak oscillatory amplitude of ∼10% of the mean amplitude. The duration of the periods with stable mean amplitude ranged from a few minutes to ∼1 h, usually interrupted by a sudden change in the activity level or by cessation of the muscle activity. Right and left trapezius muscles presented the same pattern of FM. In supplementary experiments, rhythmic muscle activity pattern was also demonstrated in the upper extremity muscles of deltoid, biceps, and forearm flexor muscles. There was no apparent association between the rhythmic components in the muscle activity pattern and the heart rate variability. To our knowledge, this is the first time that the above-described pattern of EMG activity during sleep is documented. On reanalysis of earlier recorded trapezius motor unit firing pattern in experiments on awake subjects in a situation with mental stress, low-FM of firing with similar frequency content was detected. Possible sources of rhythmic excitation of trapezius motoneurons include slow-wave cortical oscillations represented in descending cortico-spinal pathways, and/or activation by monoaminergic pathways originating in the brain stem reticular formation. The analysis of muscle activity patterns may provide an important new tool to study neural mechanisms in human sleep.

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