Monitoring of blood glucose levels, ketones and insulin bolus advice using 4SURE products and app-based technology

2022 ◽  
Vol 31 (1) ◽  
pp. 34-39
Author(s):  
Paula Johnston

With more people being diagnosed with diabetes and requiring insulin therapy as they live longer, an increasing number of individuals are needing access to blood and ketone monitoring that is simple to use and provides accurate results. Having access to a bolus advisor is equally important in order for people with diabetes to calculate accurate insulin doses based on the foods that they are eating. The use of app-based technology for healthcare purposes has increased over recent years and now includes the Diabetes:M application that can be used in conjunction with the 4SURE smart meters with no additional cost to the individual.

Author(s):  
E.Yu. Pyankova ◽  
◽  
L.A. Anshakova ◽  
I.A. Pyankov ◽  
S.V. Yegorova ◽  
...  

The problems of complications of diabetes mellitus cannot be solved without constant monitoring of blood glucose levels. The evolution of additional technologies for the determination of glucose in the blood of the last decades makes it possible to more accurately predict the risks of complications, both in the individual and in the patient population as a whole. The article provides an overview of the methods used in modern diabetology, facilitating control over the variability of blood glucose levels and helping in a more accurate selection of glucose-lowering therapy. All presented methods are currently working in real clinical practice in the Khabarovsk Krai


This case focuses on the use of intensive insulin therapy with sepsis by asking the question: What are the safety and efficacy of intensive insulin therapy compared with conventional therapy and hydroxyethyl starch (HES) compared with Ringer’s lactate in patients with severe sepsis or septic shock? This study demonstrated that critically ill patients did not benefit from intensive insulin therapy targeting blood glucose levels of 80–110 mg/dL vs. conventional insulin therapy nor from fluid resuscitation with HES vs. Ringer’s lactate. Neither intensive insulin therapy nor fluid resuscitation with HES is currently recommended in major sepsis guidelines.


2005 ◽  
Vol 35 (3) ◽  
pp. 709-712
Author(s):  
Carla de Freitas Campos ◽  
Lilian Stefanoni Ferreira ◽  
Marlos Gonçalves Sousa ◽  
Fernanda Gomes Velasque Gama ◽  
José Luiz Laus ◽  
...  

A case of a Brazilian Terrier puppy presenting diabetic lens opacity that restored transparency after insulin therapy and control of blood glucose levels is reported. This entity has been rarely reported in human beings and has not been reported in dogs before. The rapid glycemic control may have been responsible for the transparency recovery.


2018 ◽  
Vol 315 (6) ◽  
pp. E1264-E1273
Author(s):  
Ursula H. Neumann ◽  
Michelle M. Kwon ◽  
Robert K. Baker ◽  
Timothy J. Kieffer

It was long thought that the only hormone capable of reversing the catabolic consequences of diabetes was insulin. However, various studies have demonstrated that the adipocyte-derived hormone leptin can robustly lower blood glucose levels in rodent models of insulin-deficient diabetes. In addition, it has been suggested that some of the metabolic manifestations of insulin-deficient diabetes are due to hypoleptinemia as opposed to hypoinsulinemia. Because insulin therapy increases leptin levels, we sought to investigate the contribution of leptin to the beneficial effects of insulin therapy. To do this, we tested insulin therapy in streptozotocin (STZ) diabetic mice that were either on an ob/ ob background or that were given a leptin antagonist to determine if blocking leptin action would blunt the glucose-lowering effects of insulin therapy. We found that STZ diabetic ob/ ob mice have a diminished blood glucose-lowering effect in response to insulin therapy compared with STZ diabetic controls and exhibited more severe weight loss post-STZ injection. In addition, STZ diabetic mice administered a leptin antagonist through daily injection or plasmid expression respond less robustly to insulin therapy as assessed by both fasting blood glucose levels and blood glucose levels during an oral glucose tolerance test. However, leptin antagonism did not prevent the insulin-induced reduction in β-hydroxybutyrate and triglyceride levels. Therefore, we conclude that elevated leptin levels can contribute to the glucose-lowering effect of insulin therapy in insulin-deficient diabetes.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1410-1414
Author(s):  
Gnanamoorthy Kothai ◽  
Acksa Alex ◽  
Aruna Bholenath Patil ◽  
Athanallur Raman Malathy ◽  
Prasanna Karthik Suthakaran

Diabetes Mellitus (DM) is a systemic disorder characterized by hyperglycemia either due to insulin resistance or insulin deficiency. This can lead to many serious life-threatening complications if not managed properly by regular monitoring of glycemic status. Prevalence of fear of needles in the society make people non-compliant to regular monitoring. Thus, there is a need for a non-invasive method for determining the glycemic status of the individual. Salivary Glucose has the potential to be one such tool. This study aimed to find whether a correlation between fasting blood glucose levels and fasting salivary glucose levels could be established in diabetic and non-diabetic individuals. 50 patients with DM and 50 patients without DM were studied. 5 ml of venous blood and 5 ml of unstimulated saliva after overnight fasting were collected from each participant and processed using standardized enzymatic methods. The data was analyzed using SPSS software. There was a strong and very significant positive correlation (r=0.800, p=0.001) between fasting salivary glucose levels and fasting blood glucose levels in patients with DM whereas the correlation was weak and insignificant in patients without DM (r=0.111, p=0.441). The cut off value for diagnosing DM was found to be ˃ 2.2mg/dl with 100% specificity and 100% sensitivity.


2021 ◽  
Author(s):  
Tao Yuan ◽  
Hongyu He ◽  
Yuepeng Liu ◽  
Jianwei Wang ◽  
Xin Kang ◽  
...  

Abstract Background: Too high or low blood glucose levels after traumatic brain injury (TBI) negatively affect the prognosis of patients with TBI. This study aimed to examine the relationship between different levels of blood glucose in insulin therapy and Glasgow Outcome Score (GOS) in patients with TBI.Methods: This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. The information on disease, lab examination, insulin therapy, and operation of patients with TBI was collected. Also, the data on 5-year and 6-month GOS were collected as primary and secondary outcomes. The univariate analysis was used to detect variables that might contribute to outcomes, while the multivariate regression analysis was used to reveal the independent relationship between insulin therapy and outcomes. A generalized additive model (GAM) was used to investigate dose–response relationships between blood glucose levels and GOS. The results were presented as odds ratios (ORs) with their 95% confidence intervals (95% CIs). We further applied a two-piecewise linear regression model to examine the threshold effect of blood glucose level and GOS.Results: A total of 182 patients were involved in the final analysis. Compared with the non-intensive insulin therapy group, the 5-year GOS in the moderate-control intensive insulin therapy (IIT) group and the slight-control IIT group was 1.45 and 1.39 higher, respectively (both P < 0.05); the 5-year GOS in the strict-control IIT group was 0.23 higher (P > 0.05). GAM revealed that a bell-shaped relationship existed between blood glucose levels in insulin therapy and 5-year or 6-month GOS. The inflection points of the mean blood glucose level were 6.73 and 8.97 mmol/L considering 5-year GOS as the outcome and were 6.95 and 8.88 mmol/L considering 6-month GOS as the outcome. The multivariate analysis showed that the 5-year GOS in the medium-level group (≥6.73 and <8.97 mmol/L) increased by 0.83 [95% confidence interval (CI): 0.22–1.47] compared with that in the low-level group (<6.73 mmol/L). Also, the 5-year GOS in the medium-level group increased by 0.57 (95% CI: 0.02–1.08) compared with that in the high-level group (≥8.97 mmol/L).Conclusion: A proper blood glucose range in insulin therapy could improve the outcomes of patients with TBI; the range was 6.73–8.97 mmol/L according to our limited analysis.Clinical Trial Registration: ClinicalTrials.gov, NCT02161055. Registered 11 Jun 2014.


Author(s):  
J.L. Beggs ◽  
P.C. Johnson ◽  
A.G. Olafsen ◽  
C. Cleary ◽  
C.J. Watkins ◽  
...  

Nerve disease is a common complication of diabetes mellitus. Hyperglycemia directly or indirectly causes structural damage and functional impairment of nerve fibers. Despite conventional therapy, there continues to be a substantial incidence of diabetic complications. Development of complications is thought to be due to abnormal fluctuations in blood glucose levels. The number of pancreas transplants performed for the treatment of diabetic complications has increased dramatically in the last few years. Unlike conventional therapy, functional pancreas grafts provide normal fasting blood glucose levels, near-normal glucose tolerance, and normal levels of glycosylated hemoglobin. In this report, we address the following question: will functional pancreas grafts prevent or reverse the structural nerve damage caused by diabetes mellitus?A 53 y/o man developed insulin-dependent diabetes at age 35. Nephropathy, retinopathy, and neuropathy developed despite conventional insulin therapy. To treat these complications, pancreas segment transplant was performed. The donor was his identical twin. The recipient was treated with low-dose immunosuppressive drugs (azathioprine and prednisone). He has remained euglycemic for 3 years and requires neither insulin therapy nor oral hypoglycemic agents. Clinical examinations during the 3 years post-transplantation have revealed progressive improvement in vision, nerve function and a stabilization in renal function.


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