Blood Glucose Levels In Subjects Research Articles

Mathematical Models of the Effect of Glucagon on Glycemia in Individuals With Type 2 Diabetes Treated With Dapagliflozin.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors lower blood glucose levels by promoting urinary glucose excretion, but their overall effects on hormonal and metabolic status remain unclear. We here investigated the roles of insulin and glucagon in the regulation of glycemia in individuals treated with an SGLT2 inhibitor using mathematical model analysis. Hyperinsulinemic-euglycemic clamp and oral glucose tolerance tests were performed in 68 individuals with type 2 diabetes treated with the SGLT2 inhibitor dapagliflozin. Data previously obtained from such tests in 120 subjects with various levels of glucose tolerance and not treated with an SGLT2 inhibitor were examined as a control. Mathematical models of the feedback loops connecting glucose and insulin (GI model) or glucose, insulin, and glucagon (GIG model) were generated. Analysis with the GI model revealed that the disposition index/clearance, which is defined as the product of insulin sensitivity and insulin secretion divided by the square of insulin clearance and represents the glucose-handling ability of insulin, was significantly correlated with glycemia in subjects not taking an SGLT2 inhibitor but not in those taking dapagliflozin. Analysis with the GIG model revealed that a metric defined as the product of glucagon sensitivity and glucagon secretion divided by glucagon clearance (designated production index/clearance) was significantly correlated with blood glucose level in subjects treated with dapagliflozin. Treatment with an SGLT2 inhibitor alters the relation between insulin effect and blood glucose concentration, and glucagon effect may account for variation in glycemia among individuals treated with such drugs.

Blood glucose kinetics during concentric and eccentric muscle contractions

Studies comparing the two classes of stimuli (concentric and eccentric) have shown differences in the improvement of cardiovascular, metabolic, and muscle strength gain. This is an experimental, quantitative, and prospective study that aimed to verify the effect of eccentric exercise on glycolytic consumption and kinetics. The blood glucose kinetics of 17 male subjects was evaluated during a treadmill exercise with a 10% declined floor and velocity that required a 60% metabolic activity of VO2max, for 30 minutes. Seventy-two hours later, the same subjects exercised on the treadmill with a 10% inclined floor and 60% VO2max, for 30 minutes. To quantify glucose, blood samples were collected before the exercise, every three minutes along the 30 minutes of physical activity, and five and 10 minutes after finishing the exercise. For the downward slope, there was a homogeneous group behavior for blood glucose dynamics during the exercise, which was characterized by a monotonic decrease of glucose levels until reaching a minimum value at experimental times between 20 and 30 min, followed by a progressive recovery toward initial values. For the acclivity condition, blood glucose dynamics did not follow such a homogeneous behavior. A set of different types of dynamics could be identified. Experimental data showed that the type of dynamics could be predicted, to some extent, by the basal blood glucose level of subjects. The type of floor slope (upward or downward) directly affected glycolytic consumption and kinetics for the individuals analyzed.

Evaluation of technological properties, microstructure and predictive glycaemic response of durum wheat pasta enriched with psyllium seed husk

Psyllium seed husk (PSH) is a soluble dietary fibre with interesting health benefits, including reduction in blood glucose level in subjects with type 2 diabetes. Its supplementation in pasta represents a challenge due to a negative impact of high PSH levels on product acceptability. The aim of this work was to investigate the effects of the substitution of semolina with different levels of PSH on cooking properties, microstructure and in vitro glycaemic response of pasta. Dry pasta samples enriched with PSH were produced by replacing durum wheat semolina with 25, 50, 75 and 100 g/kg PSH. Cooked enriched pastas were firmer and sticker than the control. Cooking loss increased with increasing PSH levels above 25 g/kg with values below the technological acceptable limit of 80 g/kg. Semolina substitution with 50–100 g/kg psyllium was effective in lowering the predictive glycaemic response of enriched pasta in comparison with the control. Scanning electron microscopy and dough rheology (dynamic frequency and temperature sweep tests) suggested that this decrease was related to the formation of fibre aggregates limiting starch swelling. Semolina replacement with 50 g/kg PSH has the potential to provide a health benefit with minimal impact on cooking features of functional pasta.

TO STUDY THE EFFECT OF YOGA ON BLOOD SUGAR PROFILE IN DIABETICS TYPE-2 PATIENTS

Background: Yoga is a Sanskrit word meaning union. It is Hindu spiritual and self-discipline method for integrating the body, breath and mind. It is a tradition of health and spirituality that evolved in the Indian peninsula over a period of some 5000 years
 Methods: Prospective study was conducted on 100 type 2 diabetes mellitus patients and 100 normal healthy persons. Cases were recruited from a yoga centre. Control subjects were selected from diabetic patients attending hospital. Alcoholic or smoker subjects were excluded.
 Results: The mean value of blood glucose level of subjects was 7.42±1.32% and that of controls was 6.12±1.42%. The difference between the mean value of HB1Ac level determined by unpaired ‘t’ test was statistically highly significant (p=<0001).
 Conclusion: Yoga can be used as an alternate therapy to reduce the blood glucose level along with the drug therapy.
 Keywords: Yoga, Diabetics, Drugs.

TO STUDY THE EFFECT OF YOGA ON BLOOD SUGAR PROFILE IN DIABETICS TYPE-2 PATIENTS

Background: Diabetes mellitus is a syndrome complex characterized by impaired carbohydrate, protein and fat metabolism.
 Methods: Prospective study was conducted on 100 type 2 diabetes mellitus patients and 100 normal healthy persons. Cases were recruited from a yoga centre. Control subjects were selected from diabetic patients attending hospital. Alcoholic or smoker subjects were excluded.
 Results: The mean value of blood glucose level of subjects was 136.4±9.42 mg/dl and that of controls was 183.2±9.16 mg/dl. The difference between the mean value of fasting blood glucose level determined by unpaired ‘t’ test was statistically highly significant (p=<0001). The mean value of blood glucose level of subjects was 6.32±1.35 % and that of controls was 7.46±1.41%. The difference between the mean value of HB1Ac level determined by unpaired ‘t’ test was statistically highly significant (p=<0001).
 Conclusion: Yoga can be used as an alternate therapy to reduce the blood glucose level along with the drug therapy.
 Keywords: Yoga, Diabetics, Drugs.

Effect of High β-glucan Barley on Postprandial Blood Glucose Levels in Subjects with Normal Glucose Tolerance: Assessment by Meal Tolerance Test and Continuous Glucose Monitoring System.

The effect of white rice (WR) mixed with high β-glucan-containing barley at 50% on improvement of postprandial blood glucose levels was assessed by meal tolerance test and continuous glucose monitoring (CGM) in 15 healthy subjects with normal glucose tolerance (age 31.6 ± 12.9 years old, 4 males and 11 females). A meal tolerance test (500 kcal) was conducted using 2 types of test meals: a test meal only with WR and a test meal WR mixed 50% barley, and the side dish was the same in both meals. Blood glucose levels of the subjects 180 minutes after ingestion of the test meals were compared. In addition, a CGM device was attached to the subjects for 2 days when the WR or barley as a staple food was provided 3 times a day for consecutive days, and the daily variation of glucose was investigated. The glucose levels 30 minutes after dietary loads and the area under the blood concentration-time curve over 180 minutes were significantly decreased in the barley consumption group. In CGM, 24-hour mean blood glucose and 24-hour standard deviation of blood glucose were also significantly decreased after ingestion of the barley. Postprandial glucose level elevation was suppressed by mixing high-β-glucan barley with WR in subjects with normal glucose tolerance.

Immediate effect of passive static stretching versus resistance exercises on postprandial blood sugar levels in type 2 diabetes mellitus: a randomized clinical trial.

The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. In India, more than 61.3 million people have been presently diagnosed with type 2 diabetes mellitus. It is possible to control the circulating blood glucose levels by reducing life style risk factors through physical activities comprising of muscle stretches, aerobic training, resistance exercises (REs), yoga, etc. The aim of this study is to identify and compare the immediate effect of passive static stretching (PSS) versus RE on blood glucose level in individuals with type 2 diabetes mellitus. The present study included 51 participants between the age of 40–65 years with type 2 diabetes mellitus, to study the immediate effect of 60-min PSS (n=25) and 60-min RE (n=26). The outcome measure was blood glucose level which was checked by glucometer (free-style neo). Blood sugar was assessed at 3 points of time that included fasting blood sugar level, 2 hr after the meal and immediately after the exercise regimen. Results of this study showed significant reduction in blood glucose level in subjects according to glucometer with PSS (P=0.000) and RE (P=0.00). However, both groups demonstrated equal effect in terms of lowering blood sugar level immediately after the exercise. The conclusion is both PSS and RE are effective in reducing postprandial blood glucose level in type 2 diabetes mellitus and must be prescribed for the patients who demonstrate difficulty in controlling post prandial spike.

Effect of Probiotics Supplementation on Blood Glucose: a Meta-analysis of Randomized Controlled Trials

Purpose: Thisstudy was carried out as a meta-analysis to assess whether probiotics supplementation can reduce blood glucose (BG) levels in Type 2 diabetes mellitus (T2DM) patients.
 Methods: The analysis included 1005 subjects from 15 probiotics supplementation randomized trials in which changes in BG were reported as one of the end points. Summary estimates of weighted mean differences (WMDs) and 95% confidence intervals (CIs) were obtained by using random-effect models. Meta-regression and sub-group analyses were performed to identify sources of heterogeneity.
 Results: Probiotics supplementation was associated with significant decreases in BG levels (WMD: -0.29 mmol/L; 95% CI: -0.56, -0.02; P = 0.038), particularly in subjects with T2DM (WMD: -1.11 mmol/L; 95% CI: -1.54, -0.68; P< 0.001), and in trials carried out in Iran (-0.74 mmol/L; 95% CI: -1.30, -0.18; P = 0.009). Baseline BG levels were positively related to magnitude of effect (P< 0.001). Greater bene?cial effects were consistently seen in trials with baseline BG levels ? 7.0 mmol/L (WMD: -0.881 mmol/L; 95% CI: -1.357, -0.405; P < 0.001). However, in the corresponding comparison groups, magnitudes of effect were attenuated and non-signi?cant.
 Conclusion: These results indicate that probiotics supplementation is effective in reducing the BG levels in subjects with T2DM and in trials with higher baseline BG levels.

Effect of supplementation of low-molecular-weight chitosan oligosaccharide, GO2KA1, on postprandial blood glucose levels in healthy individuals following bread consumption.

The effect of chitosan oligosaccharide (GO2KA1) administration on postprandial blood glucose levels of subjects with normal blood glucose levels was evaluated following bread consumption. Postprandial blood glucose levels were determined for 2 h after bread ingestion with or without 500 mg of GO2KA1. GO2KA1 significantly lowered the mean, maximum, and minimum levels of postprandial blood glucose at 30 min after the meal. Postprandial blood glucose levels were decreased by about 25% (from 155.11±13.06 to 138.50±13.59, p<0.01) at 30 min when compared to control. Furthermore, we observed that the area under the concentration-time curve (AUCt) was decreased by about 6% (from 255.46±15.43 to 240.15±14.22, p<0.05) and the peak concentration of blood glucose (C max) was decreased by about 11% (from 157.94±10.90 to 140.61±12.52, p<0.01) when compared to control. However, postprandial the time to reach C max (Tmax) levels were the same as those found in control. Our findings suggest that GO2KA1 limits the increase in postprandial blood glucose levels following bread consumption.

Using meta-differential evolution to enhance a calculation of a continuous blood glucose level

We developed a new model of glucose dynamics. The model calculates blood glucose level as a function of transcapillary glucose transport. In previous studies, we validated the model with animal experiments. We used analytical method to determine model parameters. In this study, we validate the model with subjects with type 1 diabetes. In addition, we combine the analytic method with meta-differential evolution. To validate the model with human patients, we obtained a data set of type 1 diabetes study that was coordinated by Jaeb Center for Health Research. We calculated a continuous blood glucose level from continuously measured interstitial fluid glucose level. We used 6 different scenarios to ensure robust validation of the calculation. Over 96% of calculated blood glucose levels fit A+B zones of the Clarke Error Grid. No data set required any correction of model parameters during the time course of measuring. We successfully verified the possibility of calculating a continuous blood glucose level of subjects with type 1 diabetes. This study signals a successful transition of our research from an animal experiment to a human patient. Researchers can test our model with their data on-line at https://diabetes.zcu.cz.

Effects of Different Rehydration Fluids Supplementation on Anaerobic Power in Female Weightlifters

This study aimed to investigate the effects of supplementation of 4 rehydration solutions on fluid retention, gastro intestinal comfort, blood ionic profile, and anaerobic power in female weightlifters. In a counterbalanced, cross-over design study, 12 female weightlifters were asked to intake 4 different rehydration solutions after they lost 2% body weight through acute dehydration in sauna. The 4 types of rehydration solutions were hypoosmolar electrolyte solution (HES), iso-osmolar electrolyte solution (IES), sport beverage (SB), and water (W). The intake amount of rehydration solution was 1.5-fold to the lost of their body weight due to dehydration. Each rehydration solution was ingested immediately after dehydration, 30-min, 60-min, and 90-min of rehydration. The gastro intestinal comfort score and body weight were recorded during the rehydration period. Blood samples from each participant were collected to determine the levels of osmolarity, glucose, sodium, potassium and chloride before dehydration and during rehydration period. Wingate anaerobic test was also performed before dehydration and at 120-min of rehydration. The results indicated that gastro intestinal comfort score of the participants in HES, IES and SB supplements were significantly lower than in W supplementation at 90-min of rehydration. The blood glucose levels in subjects with HES, IES and SB treatments were significantly higher than in W treatment at 60-min. The blood potassium level in subjects with HES treatment was significantly higher than in SB and W treatments at 120-min. However, there were no significant differences on the anaerobic power and fluid retention percentage among the supplements. The major conclusion of this study is that supplementation of 4 different rehydration fluids after acute dehydration had no effects on the anaerobic power. Nevertheless, intake of the rehydration fluids containing carbohydrates and electrolytes resulted in superior scores of gastro intestinal comfort, and could maintain higher blood glucose and electrolyte concentrations.

The Effects of Using Artificial Sweeteners and Coffee Grounds in Chocolate Filling on Quality Characteristics and Glycemic Index

Chocolate is restricted for obese and diabetic patients due to high in sugar contents. We investigated shell-chocolate fillings with low calorie content and low glycemic indexes using alternative sweeteners such as tagatose and xylose and adding coffee grounds. Chocolate filling was made with sugar, cacao and butter in the original recipe. Sugar was substituted with tagatose or xylose and 3% coffee ground was added in each chocolate filling and substituted for 3% of the cocoa. Water retention and spreadability of the chocolate filling was significantly higher in the tagatose+coffee ground group in comparison to the sugar. In the chromaticity test, chocolate filling made with tagatose was darker in comparison to that made with sugar: brightness (L) was lower and redness (a) and yellowness (b) were higher than the sugar filling. Sensory evaluation revealed that chocolate filling made with tagatose had high score in 4 categories such as taste, smell, texture of foreign substance, overall acceptance. After consuming 60 g of the chocolate with different fillings, blood glucose levels of subjects at 1 and 2 h were significantly lower in the tagatose and tagatose+coffee ground groups than the other groups. In conclusion, using tagatose as the sweetener in chocolate filling has a beneficial effect on lowering blood glucose levels and increasing water retention, spreadability and sensory scores. Coffee ground did not have additive effect on quality of chocolate filling and blood glucose levels. These results indicate that shell chocolate made with tagatose can be used as a snack for diabetic patients.

PO311 EVALUATION OF PROMISING PLANT EXTRACTS AND ACTIVE CONSTITUENTS FOR ANTI OBESE, ANTI DIABETIC AND HEPATOPROTECTIVE PROPERTIES IN WNIN/GR-OB RATS

Background: Recently, skeletal muscle is recognized as an endocrine organ releasing myokines. These myokines have been shown to mediate not only health-promoting effects of physical exercise but also act favorably on insulin resistance, metabolic dysfunction, and inflammation. This study examined various myokines in patients with type 2 diabetes and pre-diabetes and compared these with normal healthy control, and assessed how they are related to various metabolic parameters, body composition, vascular stiffness and atherosclerosis. Method: One hundred forty prediabetes or diabetes patients and normal healthy controls participated in a crosssectional study. Fasting plasma glucose, HbA1c, lipid profile, insulin sensitivity index, electrical bioimpedence, pulse wave velocity, and carotid intima-media thickness (IMT) were measured. Serum irisin, IL-13, IL-6, FGF-21, fractalkine, and follistin-like 1 (FSTL1) were measured using enzyme-linked immunosorbent assay method. Result: There were significant differences in serum irisin, IL-13, IL-6, fractalkine, and FSTL1 level among normal, prediabetes, and diabetes groups. Serum irisin, IL-13, and FSTL1 levels were higher in pre-diabetes group and lower in diabetes group compared to control (P< 0.05). IL-6 and fractalkine increased gradually in the order from normal to pre-diabetes to diabetes group, and it was significantly higher in diabetes group compared to other two groups (P< 0.01). Irisin, IL-13, were in negative correlations with HbA1c, fasting glucose, 1 and 2-hour glucose (all P< 0.01) while IL-6 and fractalkine were in positive correlations (P< 0.01) after adjusting for age and gender. IL-13 showed a significant negative correlation with right mean carotid intima media thickness (IMT) after adjusting for age and gender (P< 0.05). In a multivariable model adjusted for various metabolic parameters, subjects in highest tertile of irisin levels were less likely to have type 2 diabetes compared to those in the lowest tertile (odds ratio (OR) = 0.64, 95% confidence interval (CI) 0.47– 0.88). Furthermore, multiple regression analysis showed that serum irisin level was an independent predictor of 2h plasma glucose and HbA1c level (p= 0.004). Conclusion: Various myokines including irisin, IL-6, IL-13, FSTL1, and fractalkine showed close relationships with blood glucose level in subjects within the spectrum of normal, prediabetes, and diabetes states. Irisin, IL-13, and FSTL1 seem to have a compensatory increase in prediabetes stage followed by a drop in overt diabetes stage, and they were independent predictors of the type 2 diabetes. Further study is warranted to elucidate their roles in glucose metabolism.

Blood levels of glucose and insulin and insulin resistance in patients with schizophrenia on clozapine monotherapy

ObjectiveWe tested the hypothesis that fasting blood glucose and insulin levels are higher in schizophrenic subjects on clozapine monotherapy compared with healthy controls and they correlate with anthropometric measurements, laboratory tests and body composition. MethodsData for 24 subjects with schizophrenia treated with clozapine and 24 age- and sex-matched healthy volunteers was analyzed. ResultsPatients taking clozapine had higher fasting levels of glucose (103.5±31.6 vs. 87.8±11.7mg/dL, z=−2.03, p=0.04), there was no difference for insulin concentrations and markers of insulin resistance. In the clozapine group glucose levels correlated with clozapine dose (R=−0.43, p=0.03), while insulin levels correlated with weight (R=0.66, p<0.001), body mass index (R=0.54, p=0.007), abdominal (R=0.53, p=0.007) and waist (R=0.43, p=0.04) circumference, total body fat (R=0.51, p=0.01), and uric acid levels (R=0.50, p=0.01). In the clozapine group insulin levels were lower in subjects with body mass index <25kg/m2 (7.0±3.3 vs. 13.4±8.8μU/mL, p=0.04) and in subjects without abdominal obesity (6.3±2.4 vs. 13.3±8.6μU/mL, p=0.03). ConclusionsWe found higher blood glucose levels in subjects taking clozapine and no differences in blood insulin levels between subjects with schizophrenia and controls. Associations between blood insulin levels and abdominal/waist circumferences support the role of abdominal obesity as an important risk factor of insulin resistance.

Prevalence of depression in patients with type 2 diabetes attending an outpatient clinic in India

BackgroundClinical studies have suggested that depression is common among patients with type 2 diabetes (T2D). Depression is an important factor which affects the management and complications of diabetes. However, the...

The Beneficial Effects of SesaVitaTM on Lipid Profiles and Blood Glucose Levels in Subjects With Prediabetes and Mild-To-Moderate Hyperlipidemia in India

&lt;p&gt;Individuals suffering from Type 2 diabetes develop prediabetes before progression of diabetes. In case of prediabetes people, the blood glucose levels are higher than normal but not sufficient to be diagnosed as diabetes. On the basis of existing reports on Sesame extract, SesaVita&lt;sup&gt;TM&lt;/sup&gt; which is an herbal food supplement containing Sesame seeds (&lt;em&gt;Sesamum indicum&lt;/em&gt; L.) extract may provide an option for management of prediabetes. The objective of this study was to determine the beneficial effects of SesaVita&lt;sup&gt;TM&lt;/sup&gt; in prediabetes and mild to moderate hyperlipidemia subjects. This randomized, placebo-controlled, double-blind study comprised of 13 female and 07 male patients with prediabetes and mild to moderate hyperlipidemia, aged between 18 and 65 years. Twenty subjects were randomized to receive SesaVita&lt;sup&gt;TM&lt;/sup&gt; (500 mg/day) or placebo along with therapeutic lifestyle changes for 6 weeks. The primary outcome was the measure of efficacy in terms of change in serum lipid profile and glycaemic levels on week 3 and 6. Secondary outcome measures include safety and tolerability evaluated by physical examination and clinical laboratory evaluations. Improvements in lipid profile and glycaemic levels were observed in SesaVita&lt;sup&gt;TM&lt;/sup&gt; treated group when compared with placebo and baseline. A statistical significant reduction was observed in low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), oral glucose tolerance test (OGTT) and fasting blood sugar (FBS) levels during week 3 and 6 when treated with SesaVita&lt;sup&gt;TM&lt;/sup&gt; extract.&lt;em&gt; &lt;/em&gt;No adverse events occurred and all safety parameters were within normal ranges during the study. This study revealed that the treatment with SesaVita&lt;sup&gt;TM&lt;/sup&gt; was safe and well tolerated;&lt;em&gt; &lt;/em&gt;may be beneficial in the management of prediabetes and mild-to-moderate hyperlipidemia.&lt;/p&gt;

Effect of fiber supplement on blood glucose level of niddm subjects

An investigation was undertaken to assess effect of fiber rich supplement on blood glucose level of type 2 diabetic patients. Fiber rich supplement was tested on eleven type 2 diabetic subjects for blood glucose lowering effect by undertaking an intervention of two months feeding trials. Results with respect to two months supplementation indicated that the fiber rich supplement was helpful in significantly reducing the fasting and postprandial blood glucose level of subjects. The reduction in the fasting blood glucose level after two months supplement intake was 30-70 mg/dl. While, the postprandial blood glucose values of the subjects were reduced by 92-140 mg/dl. There was reduction in the physiological symptoms at the end of the supplementation. It can be concluded from the study that the fiber rich supplement had therapeutic value as it was beneficial for lowering the blood glucose content of type 2 diabetics.

Minimally invasive insulin delivery in subjects with type 1 diabetes using hollow microneedles.

Microneedles have previously been used to deliver insulin to animal models, but not in human subjects. This study tested the hypothesis that hollow microneedles can deliver insulin to modulate blood glucose levels in subjects with type 1 diabetes in a minimally invasive manner. This study was carried out in two adults with type 1 diabetes and evaluated bolus delivery of lispro insulin using a hollow microneedle compared to a catheter infusion set (9 mm). The study first determined the minimum insulin delivery depth by administering insulin from microneedles inserted 1, 3.5, and 5 mm into the skin of fasting subjects and then assessed the efficacy of insulin delivery from microneedles inserted 1 mm into the skin to reduce postprandial glucose levels. Blood samples were periodically assayed for plasma free insulin and plasma glucose levels for up to 3.5 h. The first phase of the study indicated that microneedles inserted at the shallowest depth of 1 mm within the skin led to rapid insulin absorption and reduction in glucose levels. Bolus insulin delivery followed by consumption of a standardized meal in the second phase revealed that microneedles were effective in reducing postprandial glucose levels. Subjects reported no pain from microneedle treatments, and there were no adverse events. This study provides the first proof of concept that hollow microneedles can effectively deliver bolus insulin to type 1 diabetes subjects in a minimally invasive manner.

Clinical Update on Optimal Prandial Insulin Dosing Using a Refined Run-to-Run Control Algorithm

This article provides a clinical update using a novel run-to-run algorithm to optimize prandial insulin dosing based on sparse glucose measurements from the previous day's meals. The objective was to use a refined run-to-run algorithm to calculate prandial insulin-to-carbohydrate ratios (I:CHO) for meals of variable carbohydrate content in subjects with type 1 diabetes (T1DM). The open-labeled, nonrandomized study took place over a 6-week period in a nonprofit research center. Nine subjects with T1DM using continuous subcutaneous insulin infusion participated. Basal insulin rates were optimized using continuous glucose monitoring, with a target fasting blood glucose of 90 mg/dl. Subjects monitored blood glucose concentration at the beginning of the meal and at 60 and 120 minutes after the start of the meal. They were instructed to start meals with blood glucose levels between 70 and 130 mg/dl. Subjects were contacted daily to collect data for the previous 24-hour period and to give them the physician-approved, algorithm-derived I:CHO ratios for the next 24 hours. Subjects calculated the amount of the insulin bolus for each meal based on the corresponding I:CHO and their estimate of the meal's carbohydrate content. One- and 2-hour postprandial glucose concentrations served as the main outcome measures. The mean 1-hour postprandial blood glucose level was 104 +/- 19 mg/dl. The 2-hour postprandial levels (96.5 +/- 18 mg/dl) approached the preprandial levels (90.1 +/- 13 mg/dl). Run-to-run algorithms are able to improve postprandial blood glucose levels in subjects with T1DM.

Optical Coherence Tomography-Based Continuous Noninvasive Glucose Monitoring in Patients with Diabetes

The objective of this feasibility study was to test an optical coherence tomography (OCT)-based system for noninvasive, accurate, and continuous monitoring of blood (as opposed to interstitial) glucose concentration in subjects with diabetes. OCT uses low coherence light with precise depth focusing ability to measure changes in the microvasculature structure for glucose detection. Thirty-three subjects with diabetes had blood glucose concentrations evaluated using simultaneous capillary and OCT-based device (Sentris-100, GlucoLight, Bethlehem, PA) measurements. Subjects received a 50-g carbohydrate load at the start of the study period. Two glucose values with 60 mg separation were used to calibrate the OCT system. Six subjects were excluded (two because of hardware and/or software failures at study initiation, two because of sensor connection problems, and two others because of problems with disposable device positioning on the skin). Of the 27 subjects who completed the study, 12 had type 1 diabetes, and 15 had type 2 diabetes. Statistical analysis included plotting of the Clarke error grid, comparison to International Organization for Standardization (ISO) standards for glucose monitoring systems, and calculation of the Pearson correlation coefficient. Based on a total of 236 matched points, Clarke error grid analysis indicated 83% in zone A, 16% in zone B, and <1% in zones C and D. ISO standards comparison showed 83% of OCT estimates were within 20% of the reference value for blood glucoses >75 mg/dL. No conclusions can be made about blood glucose estimates in the <75 mg/dL range since no low reference values occurred. The Pearson correlation coefficient comparing OCT versus capillary blood glucose was 0.85 (95% confidence interval 0.81-0.88, P < 0.0001). Mean relative absolute deviation was 11.5%, and median relative absolute deviation was 8.2%. This study demonstrated that the OCT system shows acceptable accuracy in the prediction of blood glucose levels in subjects with both type 1 and type 2 diabetes. Future efforts will evaluate the accuracy of the system in the hypoglycemic range.