Blood Glucose Regulation In Type Research Articles

A bilberry drink with fermented oatmeal decreases postprandial insulin demand in young healthy adults

Backgroundin traditional medicine, blueberries have been used to facilitate blood glucose regulation in type 2 diabetes. Recent studies in diabetic mice have indicated facilitated glycaemic regulation following dietary supplementation with extracts from European blueberries, also called bilberries, (Vaccinium myrtillus). The purpose of the present study was to investigate the impact of fermented oat meal drinks containing bilberries or rosehip (Rosa canina) on glycaemic and insulinaemic responses.Methodsglycaemic and insulinaemic responses in young healthy adults were measured in two series. In series 1, two drinks based on oat meal (5%), fermented using Lactobacillus plantarum 299v, and added with fruit (10%); bilberries (BFOMD) or rose hip (RFOMD) respectively, were studied. In series 2, BFOMD was repeated, additionally, a drink enriched with bilberries (47%) was tested (BBFOMD). As control a fermented oat meal drink (FOMD) was served.Resultsin series 1 the bilberry- and rosehip drinks, gave high glucose responses similar to that after the reference bread. However, the insulin index (II) after the BFOMD was significantly lower (II = 65) (P < 0.05). In series 2 a favourably low insulin demand to BFOMD was confirmed. FOMD gave high glucose response (GI = 95) but, significantly lower insulin response (II = 76). BBFOMD gave remarkably low insulin response II = 49, and tended to lower glycaemia (GI = 79) (P = 0.0684).Conclusiona fermented oat meal drink added with bilberries induced a lower insulin response than expected from the glycaemic response. The mechanism for the lowered acute insulin demand is still unclear, but may be related to some bio-active component present in the bilberries, or to the fermented oat meal base.

Using a fuzzy controller optimized by a genetic algorithm to regulate blood glucose level in type 1 diabetes

In this paper a closed-loop control algorithm for blood glucose regulation in type 1 diabetic patients is proposed by using the Mamdani-type fuzzy method. Because of the presence of high-pass proportional derivatives in fuzzy designing, optimal values are applied for two inputs and one output membership functions in order to prevent the fluctuations due to derivatives in fuzzy design. Therefore, 19 values which are related to membership functions of the two inputs and one output are obtained by using a genetic algorithm (GA). The new model, termed the Augmented Minimal Model (AMM), is used in simulations. This controller is capable of stabilizing the blood glucose concentration at a normoglycaemic level of 90 mg dl−1. The operation of the controller under various situations including multiple meal disturbances, and noise due to inaccurate effects of measuring blood glucose level are considered. Uncertainties in the meal disturbance function and variations of model parameters were also taken into consideration in simulations and the controller was found to be robust to such uncertainties.

Robust PID Controller for Blood Glucose Regulation in Type I Diabetics

Insulin injection therapy is widely practiced for the maintenance of blood glucose levels within the normoglycemic range (70−100 mg/dL) for type I diabetics. Several proportional−integral−derivative (PID) controllers are designed using classical and modern tuning techniques, for a diabetic to specify the insulin dosage on a continuous glucose measurement basis. The PID controllers are then assessed with a detailed physiological model of diabetic patients for their ability to reject meal disturbances and their robustness in the presence of parametric uncertainties. One of the recently developed PID tuning techniques is able to maintain the glucose concentration above the hypoglycemic range (<60 mg/dL) in 95% (and 100% with fine-tuning) of 577 diabetics tested, while rejecting both single- and multiple-meal disturbance(s).

Computerization of general practices and quality control. Blood glucose regulation in type 2 diabetics investigated in the Registration Network family practices.

The extent to which computerized medical administration facilitates quality control was studied using as an example the quality of blood glucose regulation in diabetics supervised by general practitioners in 11 computerized practices. Systematic use of the general practice computer rapidly provided an unequivocal answer that 37% of such patients were not regulated in accordance with the guidelines for type 2 diabetes mellitus of the Dutch College of General Practitioners. The extra workload for the participating general practitioners was minimal. Automated recording of problem lists, as applied in the general practices belonging to the Registration Network, facilitates access to data on chronic diseases and risk factors for purposes of research, quality control and quality assessment.

Psychological stress and blood glucose regulation in Type I diabetic patients.

Fifteen Type I diabetic patients self-monitored daily mean blood glucose levels (BGL), psychological stress, diet, exercise, and insulin injections for a period of 8 weeks. Separate multiple-regression analyses were conducted for each subject to assess the predictability of BGL from stress reports, independent of the effects of diet, exercise, and insulin self-administration. Considerable individual variability in findings was evident, with stress predicting BGL in a statistically significant manner in 7 of the 15 subjects. Stress had a significant effect on BGL independent of diet, exercise, and insulin administration for each of these 7 subjects. Discussion focused on the problems of measuring the key self-management behaviors influencing BGL and on the possibility that a subgroup of diabetic patients may be BGL stress responders.

Psychological stress and blood glucose regulation in Type I diabetic patients.

Psychological stress and blood glucose regulation in Type I diabetic patients.

Pharmacokinetics of continuous subcutaneous insulin infusion

One of the reasons for the variability of blood glucose regulation in Type 1 (insulin-dependent) diabetic patients is the huge variation in subcutaneous absorption of intermediate-acting insulin. We have investigated the variation in insulin absorption during continuous subcutaneous insulin infusion in eight such patients. The content of insulin in the subcutaneous tissue was measured using 125I-labelled insulin. The concentration of free serum insulin and blood glucose was followed from 1 h before and from 7 h after breakfast on two consecutive days. The amount of insulin absorbed during 24 h differed in all cases by less than 3% from the daily insulin dose given by the pumps. Mean insulin absorption rates and mean free insulin concentration showed peak values 30-90 min after meal bolus injections; this was sufficient to maintain near-normal blood glucose. Mean free serum insulin correlated strongly with disappearance of insulin from the subcutaneous tissue (r = 0.98). From the insulin absorption rates and free insulin concentrations during basal constant insulin infusion, the half-time of serum insulin was calculated as 6 min. Compared with the known large variability in the absorption of intermediate-acting insulin, continuous subcutaneous insulin infusion offers a precise and reproducible way of insulin administration resulting in post-prandial serum insulin peaks sufficient to maintain near-normal blood glucose levels. The half-time of serum insulin during subcutaneous infusion corresponds to values for intravenous infusion given in the literature, indicating that local degradation of insulin in subcutaneous tissue is of minor importance.