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Insulin algorithm

Janusz Krzymien, Piotr Ladyzynski
The aim of this review was to investigate existing guidelines and scientific evidence on determining insulin dosage in people with type 1 and type 2 diabetes, and in particular to check whether the prandial insulin dose should be calculated based on glycemia or the meal composition, including the carbohydrates, protein and fat content in a meal. By exploring the effect of the meal composition on postprandial glycemia we demonstrated that several factors may influence the increase in glycemia after the meal, which creates significant practical difficulties in determining the appropriate prandial insulin dose...
March 13, 2019: Nutrients
Zhou Fang, Chen Weng, Haiyan Li, Ran Tao, Weihua Mai, Xiaoxiao Liu, Leina Lu, Sisi Lai, Qing Duan, Carlos Alvarez, Peter Arvan, Anthony Wynshaw-Boris, Yun Li, Yanxin Pei, Fulai Jin, Yan Li
Identification of human disease signature genes typically requires samples from many donors to achieve statistical significance. Here, we show that single-cell heterogeneity analysis may overcome this hurdle by significantly improving the test sensitivity. We analyzed the transcriptome of 39,905 single islets cells from 9 donors and observed distinct β cell heterogeneity trajectories associated with obesity or type 2 diabetes (T2D). We therefore developed RePACT, a sensitive single-cell analysis algorithm to identify both common and specific signature genes for obesity and T2D...
March 12, 2019: Cell Reports
Michael Joubert, Pierre-Yves Benhamou, Pauline Schaepelynck, Hélène Hanaire, Bogdan Catargi, Anne Farret, Pierre Fontaine, Bruno Guerci, Yves Reznik, Nathalie Jeandidier, Alfred Penfornis, Sophie Borot, Lucy Chaillous, Sylvia Franc, Pierre Serusclat, Yacine Kherbachi, Eric Bavière, Bruno Detournay, Pierre Simon, Guillaume Charpentier
Benefits of telemedicine have been proven in the field of diabetes. Among a number of technical solutions, Diabeo® has been studied in both type 1 and type 2 diabetes with intensive insulin therapy. This digital therapeutic system contains a self-monitoring glucose logbook and offers automated insulin dose recommendations thanks to a fully customizable algorithm. In addition, the cloud-based dedicated software also has features to facilitate remote monitoring, including a platform for diabetes nurses who perform coaching and treatment adjustment...
March 12, 2019: Journal of Diabetes Science and Technology
Jinying Chen, John Lalor, Weisong Liu, Emily Druhl, Edgard Granillo, Varsha G Vimalananda, Hong Yu
BACKGROUND: Improper dosing of medications such as insulin can cause hypoglycemic episodes, which may lead to severe morbidity or even death. Although secure messaging was designed for exchanging nonurgent messages, patients sometimes report hypoglycemia events through secure messaging. Detecting these patient-reported adverse events may help alert clinical teams and enable early corrective actions to improve patient safety. OBJECTIVE: We aimed to develop a natural language processing system, called HypoDetect (Hypoglycemia Detector), to automatically identify hypoglycemia incidents reported in patients' secure messages...
March 11, 2019: Journal of Medical Internet Research
Ulrike Schierloh, Malgorzata E Wilinska, Ineke M Pit-Ten Cate, Petra Baumann, Roman Hovorka, Carine De Beaufort
BACKGROUND: Studies have shown that overnight closed-loop insulin delivery can improve glucose control and reduce the risk of hypoglycemia and hence may improve metabolic outcomes and reduce burden for children with type 1 diabetes and their families. However, research so far has not reported insulin levels while comparing closed-loop to open-loop insulin delivery in children. Therefore, in this study we obtained glucose levels as well as plasma insulin levels in children with type 1 diabetes to evaluate the efficacy of a model-based closed-loop algorithm compared to an open-loop administration...
2019: PloS One
Kazuma Ogiso, Nobuyuki Koriyama, Takahiko Obo, Akinori Tokito, Takayuki Ueno, Yoshihiko Nishio
Background: Most previous insulin infusion protocols are titrated for Westerners and are not simple to follow. In this study, we tested the efficacy and safety of our simple insulin infusion protocol utilizing lower insulin doses for Asians. Methods: A total of 152 patients with type 2 diabetes undergoing cardiothoracic surgery were included. After surgery, blood glucose (BG) was initially managed according to our algorithm protocol, and subsequently by the post-algorithm protocol...
January 2019: Diabetology International
Edward Vincent S Faustino, Eliotte L Hirshberg, Lisa A Asaro, Katherine V Biagas, Neethi Pinto, Vijay Srinivasan, Dayanand N Bagdure, Garry M Steil, Kerry Coughlin-Wells, David Wypij, Vinay M Nadkarni, Michael S D Agus
OBJECTIVES: Previous studies report worse short-term outcomes with hypoglycemia in critically ill children. These studies relied on intermittent blood glucose measurements, which may have introduced detection bias. We analyzed data from the Heart And Lung Failure-Pediatric INsulin Titration trial to determine the association of hypoglycemia with adverse short-term outcomes in critically ill children. DESIGN: Nested case-control study. SETTING: Thirty-five PICUs...
February 14, 2019: Critical Care Medicine
Péter Gyuk, István Vassányi, István Kósa
According to recent surveys, the current ways of diabetics trying to estimate their insulin need based on experience and conjecture are sometimes inefficient in practice. This paper proposes a prediction algorithm and presents the validation of the model in outpatient care. The algorithm consists of two state-of-the-art models that calculate nutrition absorption and glycaemia including insulin evolution. The combined model is extended with personalized parameter training including genetic algorithm and Nelder-Mead method, and a more realistic, diurnal parameter profile as a representation of the natural biorhythm...
2019: Journal of Healthcare Engineering
Oscar D Sánchez, Eduardo Ruiz-Velázquez, Alma Y Alanís, Griselda Quiroz, Luis Torres-Treviño
The effect of meal on blood glucose concentration is a key issue in diabetes mellitus because its estimation could be very useful in therapy decisions. In the case of type 1 diabetes mellitus (T1DM), the therapy based on automatic insulin delivery requires a closed-loop control system to maintain euglycaemia even in the postprandial state. Thus, the mathematical modelling of glucose metabolism is relevant to predict the metabolic state of a patient. Moreover, the eating habits are characteristic of each person, so it is of interest that the mathematical models of meal intake allow to personalise the glycaemic state of the patient using therapy historical data, that is, daily measurements of glucose and records of carbohydrate intake and insulin supply...
February 2019: IET Systems Biology
Charrise M Ramkissoon, Arthur Bertachi, Aleix Beneyto, Jorge Bondia, Josep Vehi
The purpose of this study was to develop an algorithm that detects aerobic exercise and triggers disturbance rejection actions to prevent exercise-induced hypoglycemia. This approach can provide a solution to poor glycemic control during and after aerobic exercise, a major hindrance in the participation of exercise by patients with type 1 diabetes. This novel exercise-induced hypoglycemia reduction algorithm (EHRA) detects exercise using a threshold on a disturbance term, a parameter estimated from an augmented minimal model using an Unscented Kalman Filter...
February 11, 2019: IEEE Journal of Biomedical and Health Informatics
Liyan Pan, Guangjian Liu, Xiaojian Mao, Huixian Li, Jiexin Zhang, Huiying Liang, Xiuzhen Li
BACKGROUND: Central precocious puberty (CPP) in girls seriously affects their physical and mental development in childhood. The method of diagnosis-gonadotropin-releasing hormone (GnRH)-stimulation test or GnRH analogue (GnRHa)-stimulation test-is expensive and makes patients uncomfortable due to the need for repeated blood sampling. OBJECTIVE: We aimed to combine multiple CPP-related features and construct machine learning models to predict response to the GnRHa-stimulation test...
February 12, 2019: JMIR Medical Informatics
Li-Li Dai, Shu-De Li, Yi-Cheng Ma, Jun-Rui Tang, Jun-Yan Lv, Yuan-Qing Zhang, Ying-Lei Miu, Yan-Qiong Ma, Chun-Mei Li, Yi-You Chu, Kun-Hua Wang, Lan-Qing Ma, Cheng-Gang Zou
BACKGROUND & AIMS: Insulin resistance is strongly associated with nonalcoholic fatty liver disease, a chronic, obesity-related liver disease. Increased endoplasmic reticulum stress plays an important role in the development of insulin resistance. In this study, we investigated the roles of miRNAs in regulating ER stress in the liver of rats with obesity. METHODS: We used miRNA microarray to determine the miRNA expression profiles in the liver of rats fed a high fat diet (HFD)...
February 5, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Mayer B Davidson, S Joshua Davidson
INTRODUCTION: Primary care physicians are often challenged to adjust insulin doses. To facilitate this process, we evaluated in a safety net clinic the work flow and glycemic effects of remote glucose monitoring utilizing Federal Drug Administration (FDA) cleared, Conformité Européenne (CE) registered software that contained computerized algorithms for insulin dose adjustments to help clinicians make dosing decisions for insulin-requiring patients. METHODS: Patients taking insulin for at least 6 months with HbA1c levels of at least 8...
February 5, 2019: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
A E Ortiz-Flores, M Luque-Ramírez, E Fernández-Durán, F Alvarez-Blasco, H F Escobar-Morreale
BACKGROUND: The risk of developing prediabetes and type 2 diabetes (dysglycemia) may be increased in women with PCOS. Whether an oral glucose tolerance test (OGTT) should be performed routinely in all PCOS women at presentation or should be recommended only to a selected subset of patients is still controversial. BASIC PROCEDURES: At a tertiary care center, we conducted a retrospective, observational study including 400 women with PCOS submitted to an OGTT. Our primary objective was to assess the diagnostic agreement between two algorithms commonly used for the screening of dysglycemia in these women: i) relying only on fasting plasma glucose (FPG) or ii) considering both fasting and/or 120-min plasma glucose concentrations during an OGTT...
January 30, 2019: Metabolism: Clinical and Experimental
Martin Tauschmann, Janet M Allen, Katrin Nagl, Maria Fritsch, James Yong, Emily Metcalfe, Dominique Schaeffer, Muriel Fichelle, Ulrike Schierloh, Alena G Thiele, Daniela Abt, Harald Kojzar, Julia K Mader, Sonja Slegtenhorst, Nicole Barber, Malgorzata E Wilinska, Charlotte Boughton, Gianluca Musolino, Judy Sibayan, Nathan Cohen, Craig Kollman, Sabine E Hofer, Elke Fröhlich-Reiterer, Thomas M Kapellen, Carlo L Acerini, Carine de Beaufort, Fiona Campbell, Birgit Rami-Merhar, Roman Hovorka
OBJECTIVE: We aimed to assess the feasibility and safety of hybrid closed loop insulin delivery in children with type 1 diabetes aged 1-7 years as well as evaluate the role of diluted insulin on glucose control. RESEARCH DESIGN AND METHODS: In an open-label, multicenter, multinational, randomized crossover study, 24 children with type 1 diabetes on insulin pump therapy (median age 5 years [interquartile range 3-6] and mean ± SD HbA1c 7.4 ± 0.7% [57 ± 8 mmol/mol] total insulin 13...
January 28, 2019: Diabetes Care
Nathanaëlle Montanier, Lise Bernard, Céline Lambert, Bruno Pereira, Françoise Desbiez, Daniel Terral, Armand Abergel, Jérôme Bohatier, Eugenio Rosset, Jeannot Schmidt, Valérie Sautou, Samy Hadjadj, Marie Batisse-Lignier, Igor Tauveron, Salwan Maqdasy, Béatrice Roche
INTRODUCTION: Insulin infusion is recommended during management of diabetic patients in critical care units to rapidly achieve glycaemic stability and reduce the mortality. The application of an easy-to-use standardized protocol, compatible with the workload is preferred. Glycaemic target must quickly be reached, therefore static algorithms should be replaced by dynamic ones. The dynamic algorithm seems closer to the physiological situation and appreciates insulin sensitivity. However, the protocol must meet both safety and efficiency requirements...
2019: PloS One
Dawei Shi, Eyal Dassau, Francis J Doyle
The long-term use of the artificial pancreas (AP) requires an automated insulin delivery algorithm that can learn and adapt with the growth, development, and lifestyle changes of patients. In this work, we introduce a data-driven AP adaptation method for improved glucose management in a home environment. A two-phase Bayesian optimization assisted parameter learning algorithm is proposed to adapt basal and carbohydrate-ratio profile, and key feedback control parameters. The method is evaluated on the basis of the 111-adult cohort of the FDA-accepted UVA/Padova type 1 diabetes mellitus simulator through three scenarios with lifestyle disturbances and incorrect initial parameters...
January 2019: Bioengineering & Translational Medicine
Steffen M Heckl, Marie Pellinghaus, Sandra Krüger, Clara Bosselmann, Franziska Wilhelm, Hans-Michael Behrens, Stefan Schreiber, Christoph Röcken
Background: Metabolic reprogramming in cancer encompasses the insulin receptor (IR) as a player of energy homeostasis and proliferation. We aimed to characterize vascular (VIR) and epithelial (EIR) IR expression in CRC and correlate it with clinico-pathological parameters and survival. Methods: 1580 primary CRCs were explored by immunohistochemistry for evaluation of VIR and EIR. Subgroup analyses included in situ hybridization for IR isoform A (IR-A) and DNA mismatch repair protein immunohistochemistry...
December 25, 2018: Oncotarget
Nasseh Hashemi, Tim Valk, Kim Houlind, Niels Ejskjaer
BACKGROUND: Optimal glucose control has been shown to be useful in critical care as well as in other settings. Glucose concentrations in patients admitted to critical care are characterized by marked variability and hypoglycemia due to inadequate sensing and treatment technologies. METHODS: The insulin balanced infusion system (IBIS) is a closed-loop system that uses a system controller, two syringe pumps, and capillary glucose sensor intravenously infusing regular insulin and/or dextrose...
January 24, 2019: Journal of Diabetes Science and Technology
Manoj Kumar Pujar, Basavaraj Vastrad, Chanabasayya Vastrad
: Insulin resistance is present in the majority of patients with non-insulin-dependent diabetes mellitus (NIDDM) and obesity. In this study, we aimed to investigate the key genes and potential molecular mechanism in insulin resistance. Expression profiles of the genes were extracted from the Gene Expression Omnibus (GEO) database. Pathway and Gene Ontology (GO) enrichment analyses were conducted at Enrichr. The protein⁻protein interaction (PPI) network was settled and analyzed using the Search Tool for the Retrieval of Interacting Genes (STRING) database constructed by Cytoscape software...
January 22, 2019: Biomolecules
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