Investigation of insulin clearance in septic patients with glucose intolerance: analysis under strict blood glucose control by means of artificial pancreas

The aim of this study was to construct a glucose regulatory algorithm by employing the natural pulsatile pattern of insulin secretion and the oscillatory pattern of resting blood glucose levels and further to regulate the blood glucose level in diabetic pigs by this method. We developed a control algorithm based on repetitive intravenous bolus injections of insulin and combined this with an intravascular blood glucose monitor. Four anesthetized pigs were used in the study. The animals developed a mildly diabetic state from streptozotocin pretreatment. They were steadily brought within the blood glucose target range of 4.5–6.0 mmol/L in 21 to 121 min and kept within that range for 128 to 238 min (hypoglycemic values varied from 2.9 to 51.1 min). The study confirmed our hypotheses regarding the feasibility of this new principle for blood glucose control, and the algorithm was constantly improved during the study to produce the best results in the last animals. The main obstacles were the drift of the IvS-1 sensor and problems with the calibration procedure, which calls for an improvement in the sensor stability before this method can be applied fully in new studies in animals and humans.

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Artificial Pancreas: from in-silico to in-vivo∗∗This work was supported by the Fondo per gli Investimenti della Ricerca di Base project Artificial Pancreas: In Silico Development and In Vivo Validation of Algorithms for Blood Glucose Control funded by Italian Ministero dell'Istruzione, dell'Universitä e della Ricerca.

IFAC-PapersOnLine ◽

10.1016/j.ifacol.2015.09.148 ◽

2015 ◽

Vol 48 (8) ◽

pp. 1300-1308 ◽

Cited By ~ 5

Author(s):

M. Messori ◽

C. Cobelli ◽

L. Magni

Keyword(s):

Blood Glucose ◽

Glucose Control ◽

In Silico ◽

Artificial Pancreas ◽

Blood Glucose Control ◽

In Vivo Validation

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Evolution Of β-Tg Level In Diabetic Patients Undergoing Artificial Pancreas Treatment

10.1055/s-0038-1653366 ◽

1981 ◽

Author(s):

Ph Voisin ◽

D Rouselle ◽

C Guimont ◽

P Drouin ◽

J F Stoltz

Keyword(s):

Blood Glucose ◽

Glucose Control ◽

Healthy Subjects ◽

Artificial Pancreas ◽

Blood Glucose Control ◽

Specific Protein ◽

Diabetic Patients ◽

Glucose Levels ◽

Insulin Dependent ◽

Insulin Dependent Diabetic

Plasma β-thromboglobulin was measured at 0, 24 and 48 hours on 27 healthy subjects and 22 insulin-dependent diabetic patients undergoing a 48-hour artificial pancreas treatment (Biostator).Before treatment all the diabetic patients revealed β-TG levels which were significantly higher than those measured in healthy subjectsOn average, after 24 hours of blood glucose control, β-TG levels in the diabetic patients were not significantly reduced in comparison with the original β-TG levels. In contrast, after 48 hours of blood glucose control, plasma β-TG levels were significantly reduced.As β-TG is a platelet-specific protein, which is considered to be an indicator of the cell’s release reaction, these results suggest that short-term control of blood glucose levels is likely to influence platelet activation in diabetic patients.

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