Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Megan Rodrigues ◽  
Pratibha Rana ◽  
Gene Lee ◽  
Chaitali Mahajan ◽  
Michael Nyp ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Intrauterine Growth Restriction ◽  
Clinical Characteristics ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Preterm Neonates ◽  
Hyperinsulinemic Hypoglycemia ◽  
Glucose Levels ◽  
Normal Glucose ◽  
Short Time

Abstract Objectives Describe clinical characteristics, course, and risk factors for hyper-insulinemic hypoglycemia (HIH) in preterm infants and identify impediments to early diagnosis. Methods Electronic records of infant–mother dyads were used to describe clinical characteristics, lab parameters, and course of HIH. Results All eight patients (gestational ages 26w0d–29w3d) had intrauterine growth restriction (IUGR) due to placental insufficiency, (4/8) were small for gestational age. All maintained normal glucose levels with glucose infusion during the first 48 h six of eight patients had cholestasis despite being on parenteral nutrition for short time (average 17 days). Four of eight patients were treated with diazoxide (average 22 days). Four of eight patients who recovered spontaneously (average 49 days after diagnosis) responded to continuous feeds and hydrocortisone for other clinical indications. Conclusions In IUGR preterms, HIH is asymptomatic, may be prolonged, requiring diazoxide treatment. Transient cholestasis is seen in majority of patients. Euglycemia should be demonstrated on bolus gavage feeds, off glucocorticoids before discontinuing blood glucose monitoring.

scholarly journals A Review of Non-Invasive Optical Systems for Continuous Blood Glucose Monitoring

Sensors ◽  
2021 ◽  
Vol 21 (20) ◽  
pp. 6820
Author(s):  
Bushra Alsunaidi ◽  
Murad Althobaiti ◽  
Mahbubunnabi Tamal ◽  
Waleed Albaker ◽  
Ibraheem Al-Naib
Keyword(s):  
Blood Glucose ◽  
Glucose Monitoring ◽  
Daily Basis ◽  
Glucose Sensing ◽  
Blood Glucose Monitoring ◽  
Optical Systems ◽  
Glucose Levels ◽  
Non Invasive ◽  
Blood Glucose Levels ◽  
Continuous Blood Glucose Monitoring

The prevalence of diabetes is increasing globally. More than 690 million cases of diabetes are expected worldwide by 2045. Continuous blood glucose monitoring is essential to control the disease and avoid long-term complications. Diabetics suffer on a daily basis with the traditional glucose monitors currently in use, which are invasive, painful, and cost-intensive. Therefore, the demand for non-invasive, painless, economical, and reliable approaches to monitor glucose levels is increasing. Since the last decades, many glucose sensing technologies have been developed. Researchers and scientists have been working on the enhancement of these technologies to achieve better results. This paper provides an updated review of some of the pioneering non-invasive optical techniques for monitoring blood glucose levels that have been proposed in the last six years, including a summary of state-of-the-art error analysis and validation techniques.

scholarly journals VP184 A Cost Analysis Of Flash Glucose Monitoring Systems In Veneto Region

2017 ◽  
Vol 33 (S1) ◽  
pp. 235-236
Author(s):  
Alessandro Curto ◽  
Marika Torbol ◽  
Anna Cavazzana ◽  
Margherita Andretta ◽  
Giovanna Scroccaro
Keyword(s):  
Blood Glucose ◽  
Cost Analysis ◽  
New Technology ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Veneto Region ◽  
Glucose Levels ◽  
Medical App ◽  
The Impact

INTRODUCTION:A novel, sensor-based, factory-calibrated Flash Monitoring System (FMS) has recently proved to be an effective alternative to conventional self-monitoring of blood glucose (SMBG) in patients affected by type 1 and type 2 diabetes. The 14-days adhesive sensor, that continuously measures glucose levels in the interstitial fluid, can transfer glucose levels data to a handheld reader or a smartphone equipped with a specific medical app. The uptake of the new technology has been limited so far, because of its high costs. A cost analysis has been conducted to identify the optimal target population of introducing FSM in Veneto.METHODS:The model was designed with a 1-year time horizon for patients with diabetes using intensive insulin in Veneto region. The costs of the new technology was estimated using inputs from the two main randomized controlled trials (the IMPACT study and the REPLACE study) published in the international literature, Regional evidence-based guidelines and administrative database. Resource utilization included strips, lancets, needles, sensors, distribution and patients training. Regional unit costs were adopted.RESULTS:FSM has not shown so far relevant and statically significant benefits in terms of severe adverse events’ reduction. Estimated yearly costs for a FSM user included glucose monitoring, technology training and distribution costs, for a total of EUR1277 per patient. The new technology has been shown to be affordable in diabetic patients with i) 4years<age<18years, ii) continuous subcutaneous insulin infusion and iii) ≥5 blood glucose monitoring per day.CONCLUSIONS:The Veneto Region should carefully consider prescribing extension to other diabetic patients categories, since the high cost of the new technology. A strict prescribing monitoring is strongly recommended with the aim of ensuring appropriateness and avoiding overspending.

scholarly journals The dynamics of invasive and noninvasive blood glucose monitoring methods: Recent trends

2016 ◽  
Vol 19 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Alina Yur'evna Babenko ◽  
Yulia Alexeevna Kononova ◽  
Alexandr Ivanovich Tsiberkin ◽  
Michail Konstantinovich Khodzitsky ◽  
Elena Nilkolaevna Grineva
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Control ◽  
Glucose Monitoring ◽  
Cost Effective ◽  
Disease Status ◽  
Accurate Method ◽  
Blood Glucose Monitoring ◽  
Monitoring Methods ◽  
Glucose Levels ◽  
Blood Glucose Levels

Improved prognoses of patients with type 2 diabetes are primarily determined by the extent of blood glucose control (correction of both hyper- and hypoglycemia and normalization of blood glucose levels). The proper identification and timely correction of abnormal blood glucose levels require frequent blood glucose monitoring by the patient. Currently used methods for the self-monitoring of blood glucose have significant drawbacks that limit their use. The most significant problems with these methods include insufficient accuracy, invasiveness and high cost, leading to noncompliance and difficult assessment of disease status. Such factors underscore the need for a noninvasive, cost-effective and highly accurate method to measure blood glucose levels. There are several different approaches for the noninvasive measurement of blood glucose levels, including optical analysis, ultrasound and bioimpedance. The concept of a noninvasive glucometer was launched more than 30 years ago. Nevertheless, most noninvasive technologies are still in early stages of development and are not used in clinical practice. This review describers the most promising developments in this area.

Evaluating the influence of hematocrit: comparison of three POCT devices pursuant to ISO 15197 guidelines. (Preprint)

2021 ◽  
Author(s):  
Matthes Kenning ◽  
Anselm Puchert ◽  
Eckhard Salzsieder
Keyword(s):  
Blood Glucose ◽  
Health Care Professionals ◽  
Glucose Monitoring ◽  
Clinical Importance ◽  
Blood Glucose Monitoring ◽  
Glucose Levels ◽  
Continuous Quality ◽  
Blood Glucose Levels ◽  
Reference Device ◽  
Personal Use

BACKGROUND Maintaining normal blood glucose levels in diabetes therapy is fundamentally linked to precise and accurate blood glucose measurements. In the light of interfering quantities like various substances or hematocrit, these aspects are of utmost clinical importance within a standardized validation of blood glucose monitors for personal use as well as a continuous quality assessment. OBJECTIVE Continuous and independent quality assurance of aspects affecting a blood glucose monitoring system’s performance. METHODS The influence of the hematocrit on the performance of three blood glucose monitors was assessed in accordance with ISO 15197 and sponsor’s requirements. RESULTS Only one device showed acceptable deviations of ≤ 10 mg/dL / 10 % to the reference device across the entire range. The other devices showed minor to clinically relevant interferences, particularly in response to higher hematocrit values. CONCLUSIONS Suitable BGM systems should be selected carefully by health care professionals and patients, especially with medical conditions known to interfere with blood glucose measurements.

Blood Glucose Monitoring In Pediatric Patients—Looking Toward Better Diabetes Management and Perspectives for the Future

2010 ◽  
Vol 06 (01) ◽  
pp. 54
Author(s):  
William L Clarke ◽  
Keyword(s):  
Blood Glucose ◽  
Diabetes Management ◽  
Artificial Pancreas ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Blood Glucose Monitoring ◽  
Intensive Glucose Control ◽  
Nocturnal Hypoglycemia ◽  
Glucose Levels ◽  
Analytical Accuracy

Self-blood glucose monitoring (SBGM) is an important component of day-to-day diabetes management for children and their families. Despite some recent concerns in terms of its analytical accuracy, it has been used successfully to implement intensive glucose control in the Diabetes Control and Complications Trial, reduce glycated hemoglobin (HbA1c) levels, prevent acute complications, and make it possible for children to attend school and participate in sports activities safely. While still in its infancy, continuous glucose monitoring (CGM) has been shown to be useful in reducing the occurrence of nocturnal hypoglycemia, lowering HbA1clevels, and reducing glycemic variability. Its analytical accuracy has prevented its approval as an alternative to SBGM for insulin decision-making. However, it has made possible the development and testing of closed-loop ‘artificial pancreas’ systems for controlling glucose levels in adults and adolescents.

Performance of Seven Blood Glucose Testing Systems at High Altitude

1989 ◽  
Vol 15 (5) ◽  
pp. 444-448 ◽  
Author(s):  
Beverlyp. Giordano ◽  
Wayne Thrash ◽  
Laura Hollenbaugh ◽  
William P. Dube ◽  
Carol Hodges ◽  
...  
Keyword(s):  
Blood Glucose ◽  
High Altitude ◽  
Health Care Professionals ◽  
System Performance ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Monitoring Systems ◽  
Glucose Levels ◽  
Glucose Testing ◽  
Blood Glucose Testing

Consumers and health care professionals expect blood glucose monitoring systems to consistently generate results that are close to actual blood glucose levels. Numerous environmental, physiologic, and operational factors can affect system performance, yielding results that are inaccurate or unpredictable. This study examined the effect of one factor—high altitude—on the performance of seven blood glucose monitoring systems. One of the systems overestimated blood glucose results; the other six systems underestimated blood glucose values (more than the expected variance). The findings of this study support previous reports of altered blood glucose monitoring system performance at high altitude. Diabetes educators can use this information when counseling consumers who reside or who plan to visit locations at high altitude.

scholarly journals Glycemic deviation index: a novel method of integrating glycemic numerical value and variability

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yizhou Zou ◽  
Wanli Wang ◽  
Dongmei Zheng ◽  
Xu Hou
Keyword(s):  
Blood Glucose ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Deviation Index ◽  
Multiple Characteristics ◽  
Novel Method

Abstract Background There are many continuous blood glucose monitoring (CGM) data-based indicators, and most of these focus on a single characteristic of abnormal blood glucose. An ideal index that integrates and evaluates multiple characteristics of blood glucose has not yet been established. Methods In this study, we proposed the glycemic deviation index (GDI) as a novel integrating characteristic, which mainly incorporates the assessment of the glycemic numerical value and variability. To verify its effectiveness, GDI was applied to the simulated 24 h glycemic profiles and the CGM data of type 2 diabetes (T2D) patients (n = 30). Results Evaluation of the GDI of the 24 h simulated glycemic profiles showed that the occurrence of hypoglycemia was numerically the same as hyperglycemia in increasing GDI. Meanwhile, glycemic variability was added as an independent factor. One-way ANOVA results showed that the application of GDI showed statistically significant differences in clinical glycemic parameters, average glycemic parameters, and glycemic variability parameters among the T2D groups with different glycemic levels. Conclusions In conclusion, GDI integrates the characteristics of the numerical value and the variability in blood glucose levels and may be beneficial for the glycemic management of diabetic patients undergoing CGM treatment.

Evaluation of Nursing Work Effort and Perceptions About Blood Glucose Testing in Tight Glycemic Control

2006 ◽  
Vol 15 (4) ◽  
pp. 370-377 ◽  
Author(s):  
Daleen Aragon
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Tight Glycemic Control ◽  
Blood Glucose Monitoring ◽  
Glucose Levels ◽  
Glucose Testing ◽  
Intravenous Insulin ◽  
Blood Glucose Levels ◽  
Blood Glucose Testing

• Background Tight glycemic control is important in critically ill patients and involves insulin infusions and monitoring of blood glucose levels. Hourly measurements of blood glucose levels and adjustments of intravenous insulin doses require additional work by nurses. • Objectives To evaluate the nursing work incurred with and nursing perceptions about tight glycemic control and blood glucose monitoring. • Methods A variety of intensive care units were studied. Surveys were used to gain information about nurses’ perceptions. Time-in-motion observations were used to determine the time taken to measure blood glucose levels and adjust insulin doses. • Results Nurses thought that tight glycemic control was important and that the work associated with it was substantial. Nurses thought that easier and automated forms of blood glucose monitoring are needed. They preferred using an arterial catheter to obtain blood samples to avoid excessive finger sticks. The total number of blood glucose measurements was 77 954. The mean time taken for hourly blood glucose monitoring and adjustment of insulin doses was 4.72 minutes. The estimated costs of time spent on glycemic control during a 1-year period were $182 488 for nurses’ salaries and $58 500 for supplies. • Conclusions Although most nurses endorse tight glycemic control, the work associated with it is burdensome and costly. Because up to 2 hours might be required for tight glycemic control for a single patient in a 24-hour period, the costs in time and money are high. Easier clinical methods for monitoring blood glucose levels are needed.

scholarly journals Phantoms for Development of Microwave Sensors for Noninvasive Blood Glucose Monitoring

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jan Vrba ◽  
Jakub Karch ◽  
David Vrba
Keyword(s):  
Blood Glucose ◽  
Microstrip Antenna ◽  
Glucose Monitoring ◽  
Physiological Saline ◽  
Blood Glucose Monitoring ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Microwave Sensor ◽  
Microwave Sensors

A suitability of two different liquid phantoms of blood-glucose solutions as phantoms for development of microwave sensors for noninvasive blood glucose monitoring is compared. The two phantoms are physiological saline-glucose and pig blood-glucose solutions. For this purpose a simple microwave sensor is developed for in vitro monitoring of blood glucose levels. The sensor consists of a microstrip antenna and of a small rectangular container on the top of the antenna. The container is filled with one of the liquid phantoms. Both phantoms with different glucose concentrations ranging from 0 to 500 mg/dL are considered. Dependence of sensor’s resonant frequency on glucose concentration of LUTs is both estimated by aid of numerical simulations and measured. The results are discussed and compared with some results reported in the literature.

Sign in / Sign up

Export Citation Format

Share Document