Blood Glucose Levels In Individuals Research Articles

Effectiveness of glucagon-like peptide-1 receptor agonists for reduction of body mass index and blood glucose control in patients with type 2 diabetes mellitus and obesity: A retrospective cohort study and difference-in-difference analysis

ObjectiveThis study aimed to evaluate the effectiveness of glucagon-like peptide-1 receptor agonists (GLP-1RA) in reducing body mass index (BMI) and blood glucose levels in individuals with type 2 diabetes mellitus...

Pendampingan Aktifitas Senam Kaki bagi Peserta Prolanis Diabetes Melitus di Wilayah Kerja Puskesmas Kujangsari Kota Bandung

Prediabetic individuals participating in the Prediabetes Lifestyle Program (prolanis DM) have exhibited irregular adherence to lower limb exercises, resulting in persistent fluctuations in blood glucose levels. Engaging in lower limb exercises holds substantial benefits for stabilizing blood glucose levels in individuals with diabetes mellitus (DM). This community nursing intervention aims to enhance the ability of prediabetic prolanis participants to perform lower limb exercises. The intervention involves direct assistance and guidance to prediabetic prolanis participants during their lower limb exercise routines. A total of 31 participants were provided with instructional videos on DM-specific lower limb exercises and were evaluated twice over two months during their visits to the Kujangsari Primary Health Center. After the sessions, the lower limb exercises were assessed using a scoring format ranging from 1 to 3, with final results categorized accordingly. Results indicated that 54.8% of participants achieved a 'Good' rating for their lower limb exercise performance. This personalized support and guidance are anticipated to augment the participants' lower limb exercise proficiency and motivation to exercise regularly. The DM-specific lower limb exercise videos are envisioned to serve as a reference for participants, enabling them to pursue self-care by performing these exercises at home and maintaining stable blood glucose levels.

The Potential of Red Betel Leaf and Mangosteen Peel in Lowering Blood Sugar Levels in Patients with Diabetes Mellitus

A study comparing the effects of red betel leaf decoction, mangosteen peel juice, and conventional medication on blood glucose levels in individuals with type II diabetes mellitus was conducted in Indonesia. The research involved three groups of eight participants each, selected through purposive sampling. Following administration, the average blood glucose level was 190.75 mg/dL for red betel leaf decoction, 194.38 mg/dL for mangosteen peel juice, and 186.50 mg/dL for conventional medication. Surprisingly, there was no significant difference in the effectiveness of red betel leaf decoction and mangosteen peel juice in managing blood sugar levels, with a p-value of 0.582 (p<0.05). These findings suggest that both herbal interventions are comparable to conventional medication in regulating blood glucose levels among type II diabetes patients. In conclusion, the study highlights the potential of red betel leaf and mangosteen peel as alternative non-pharmacological interventions for managing diabetes. Further research is warranted to explore their mechanisms of action and long-term effects on diabetes management

The consumption of walnuts has an impact on decreasing fasting blood glucose levels in individuals with concurrent hyperglycemia and hyperlipidemia: a randomized control trial

Nationally, the prevalence of Diabetes Mellitus (DM) has increased by 0.5%. In 2013, it was approximately 1.5%, rising to 2.0% in 2018. On the other hand, it is known that administering walnut extract can reduce blood sugar levels in diabetic patients. The aim of this study is to determine the effect of walnut consumption on blood sugar levels. The research was conducted experimentally, using a pre-post test control group design. The research sample consisted of mothers with fasting blood sugar levels ≥200 mg/dL and total cholesterol levels ≥200 mg/dL (hyperglycemic and hyperlipidemic). The total sample size was 50 mothers, divided into 2 groups. Samples were selected using simple random sampling. The intervention involved giving 50 grams of walnut (Canarium Indicum L.) daily for 8 weeks to the treatment group. The research was conducted in the working area of the Paccerakang Community Health Center in Makassar City, Indonesia. Statistical analysis was performed using paired T-tests. There was a decrease in fasting blood glucose levels in the treatment group from 244.12 mg/dL to 195.52 mg/dL. In the control group, there was a slight decrease in blood sugar levels from 236.92 mg/dL to 229.96 mg/dL. Paired T-test analysis in the treatment group showed a value of p=0.00, indicating a significant difference in cholesterol levels before and after the intervention in the treatment group. In the control group, the value was p=0.07, indicating no significant difference in cholesterol levels in the control group. Administering 50 grams of walnuts per day for 8 weeks significantly lowered fasting blood sugar levels in hyperlipidemic and hyperglycemic mothers.

Optimizing Blood Glucose Regulation in Type 1 Diabetes Patients via Genetic Algorithm-Based Fuzzy Logic Controller Considering Substantial Meal Protocol

Effective management of blood glucose levels in individuals with type 1 diabetes, especially after meals, is crucial for diabetes care. Artificial pancreas systems (APS) perform automated insulin delivery in subjects with type 1 diabetes mellitus (T1DM). In this study, an optimized fuzzy logic controller was designed to achieve a euglycemic range after a substantial meal intake. All in silico simulations were performed using the MATLAB/Simulink environment, leveraging control variability grid analysis (CVGA), and the performance of the controller was evaluated. The proposed controller is based on a fuzzy-logic control law designed in three stages. First, a nonlinear framework of the glucose-insulin regulatory system was identified based on the heavy meal protocol of three patients given as follows: for subject ID 117-1, a total of 295 gCHO; for subject ID 126-1, 236 gCHO; and subject ID 128-1, 394 gCHO over a day. Then, an iterative tree structure was employed to establish a stabilizing control rule for insulin delivery, integrating inputs from two Mamdani Fuzzy Inference System (FIS) objects. Finally, a genetic algorithm refines the control system by fine-tuning the uncertainty of the fuzzy membership functions. Two scenarios were considered for three patients to assess the performance of the proposed controller. The results indicated its effectiveness under various conditions, achieving a time in the range of 61.25%, 71% and 61.10% respectively for the three subjects. The obtained results are analyzed and compared with IMC and multi-objective output feedback controllers. The findings of the study reveal that the proposed controller shows promising advancements in tailored strategies for type 1 diabetes patients, outperforming the other controllers in terms of blood glucose regulation.

Optimizing blood glucose regulation in type 1 diabetes: A fractional order controller approach

This study presents the design and implementation of a Fractional Order Proportional, Integral, and Derivative (FOPID) controller intended for the regulation of blood glucose levels in individuals with type 1 diabetes mellitus (T1DM). The efficacy of this controller is evaluated through its application to a nonlinear Stolwijk–Hardy model simulating T1DM patients, accounting for a range of physiological conditions. Utilizing a genetic algorithm, the parameters of the FOPID controller are fine-tuned. By conducting a comparative analysis with previously established control algorithms, the performance of the proposed controller is validated, demonstrating its superior performance. The results underscore the significant improvements achieved by the proposed controller in maintaining blood glucose concentrations within safe thresholds, particularly in scenarios involving disruptions due to meals.

Hubungan faktor metabolik dan konsumsi makanan minuman manis dengan kadar gula darah pada usia 30-60 tahun di Puskesmas Simalingkar

High blood glucose levels (hyperglycemia) can be caused by several conditions, including diabetes mellitus (DM). Among the top 5 nations in the world with the most DM cases in 2021 is Indonesia. There are 161,267 DM patients in North Sumatra, with 31,482 cases in Medan. Simalingkar Community Health Center is one of the health centers in Medan with the highest number of DM cases in 2022. This study intends to examine the association between blood glucose levels in individuals aged 30 to 60 at Simalingkar Community Health Center and metabolic variables, particularly obesity as assessed by body mass index (BMI) and belly circumference, as well as the consumption of sugary foods and beverages. This research is a cross-sectional study. 120 participants were included in this research sample and use accidental sampling method. Data analysis was done univariately, bivariately using the chi-square test and multivariately using logistic regression. The results showed that BMI (RP=1.701; 95% CI=1.095–2.645; p=0.022), abdominal circumference (RP=2.124; 95% CI=1.253–3.600; p=0.003) and sweet foods and beverages consumption (RP=2.042; 95% CI=1.358–3.069; p=0.001) were significantly associated with blood glucose levels. The habit of consuming sweet foods and drinks is the most dominant factor influencing a person to experience hyperglycemia (OR=3,345; 95% CI=1,512-7,387). The community is advised to control blood glucose levels by maintaining ideal body weight and reducing consumption of sweet foods and beverages to prevent type 2 DM.

The effect of mindful eating on dietary behaviour and fasting blood glucose in type 2 diabetes mellitus patients

Diet plays a pivotal role in the comprehensive therapy for individuals with type 2 diabetes mellitus, contributing significantly to maintaining stable glycemic control. Mindful Eating, as an intervention, focuses on enhancing dietary behavior by directing attention, thoughts, and feelings towards eating activities. This study aimed to investigate the impact of mindful eating on dietary behavior and fasting blood glucose levels in individuals with type 2 diabetes mellitus. Employing a quasi-experimental method with a pretest-posttest control group design, the study included a sample of 63 participants (selected through convenience sampling). Data collection utilized the Personal Diabetes Questionnaire (PDQ) and a glucometer. Statistical analysis involved Wilcoxon, Mann-Whitney, and Independent T-tests. The findings revealed that mindful eating exercises had a significant influence on dietary behavior (p = 0.025) and fasting blood glucose levels (p = 0.033). The practice of mindful eating led to notable improvements in dietary behavior and ensured controlled fasting blood glucose levels by the study's conclusion. Incorporating mindful eating exercises into eating patterns is recommended as a crucial aspect of diabetes management, aiming to enhance dietary behavior and sustain stable glycemic control.

Preventing severe hypoglycemia in adults with type 2 diabetes (PHT2): Design, delivery and evaluation framework for a randomized controlled trial

BackgroundSevere hypoglycemia is a common and feared complication of medications used to lower blood glucose levels in individuals with diabetes. Psychoeducational interventions can prevent severe hypoglycemia in individuals with type 1 diabetes (T1D). We aim to determine the effectiveness of this approach among adults with type 2 diabetes (T2D) at elevated risk for severe hypoglycemia. MethodsPreventing Hypoglycemia in Type 2 diabetes (PHT2) is a two-arm, parallel, randomized controlled trial. Participants are eligible if they are adults with T2D receiving care at an integrated group practice in Washington state and have experienced one or more episodes of severe hypoglycemia in the prior 12 months or have impaired awareness of hypoglycemia (Gold score ≥ 4). Participants are randomized to proactive nurse care management with or without my hypo compass, an evidence-based, psychoeducational intervention combining group and individual self-management training. For this study, my hypo compass was adapted to be suitable for adults with T2D and from an in-person to a virtual intervention over videoconference and telephone. The primary outcome is any self-reported severe hypoglycemia in the 12 months following the start of the intervention. Secondary outcomes include biochemical measures of hypoglycemia, self-reported hypoglycemia awareness, fear of hypoglycemia, and emergency department visits and hospitalizations for severe hypoglycemia. The study includes a process evaluation to assess implementation fidelity and clarify the causal pathway. ConclusionThe PHT2 trial will compare the effectiveness of two approaches for reducing severe hypoglycemia in adults with T2D.Trial registration: clinicaltrials.gov, # NCT04863872

Antidiabetic Activity, Phytochemical Analysis, and Acute Oral Toxicity Test of Combined Ethanolic Extract of Syzygium polyanthum and Muntingia calabura Leaves.

Syzygium polyanthum is known for its capacity to regulate blood glucose levels in individuals with diabetes, while Muntingia calabura leaves have a traditional history as an alternative therapy due to their antidiabetic compounds. The combination of these two plants is expected to yield more optimized antidiabetic agents. This study aims to assess the antidiabetic activity of the combined ethanolic extract of S. polyanthum and M. calabura leaves by measuring the in vitro inhibition of the α-glucosidase enzyme and the blood glucose level in streptozotocin-induced rats and to determine the phytochemical contents of total phenolics, total flavonoids, and quercetine as marker compounds. Acute oral toxicity test was also evaluated. Both plants were extracted by maceration using 96% ethanol. Various combinations of S. polyanthum and M. calabura leaves extracts (1 : 1, 2 : 1, 3 : 1, 1 : 3, and 1 : 2) were prepared. The in vitro test, along with the total phenolic and total flavonoid content, were measured by using UV-Vis spectrophotometry, while quercetine levels were quantified through high-performance liquid chromatography (HPLC). The in vivo and acute toxicity tests were performed on rats as an animal model. The findings demonstrated that the 1 : 1 combination of S. polyanthum and M. calabura leaves ethanolic extract displayed the highest enzyme inhibitory activity with IC50 value of 36.43 µg/mL. Moreover, the combination index (CI) was found <1 that indicates the synergism effect. This combination also decreases the blood glucose level in rats after 28 days of treatments without significant difference with positive control glibenclamide (p > 0.005), and it had medium lethal doses (LD50) higher than 2000 mg/kg BW. Phytochemical analysis showed that the levels of total phenolics, total flavonoids, and quercetine were 30.81% w/w, 1.37% w/w, and 3.25 mg/g, respectively. These findings suggest the potential of combined ethanolic extracts of S. polyanthum and M. calabura leaves (1 : 1) as raw materials for herbal antidiabetic medication.

Impact of Anaemia on HbA1c Interpretation Among Normogylcaemic Individuals With Diabetes Mellitus: A Clinical Laboratory Observational Study.

Over the past decades, glycosylated haemoglobin (HbA1c) has been a gold standard for monitoring diabetes control over a long period, relative to blood glucose level (BGL) which measures short-term results. It is speculated that anaemia and factors that induce haemolysis may cause falsely elevated HbA1c leading to 'false positive' interpretations. This study aimed to investigate how anaemia impacts HbA1c. This was a pathology-based observational pilot study using archived data of diabetic subjects monitored with both BGL and HbA1c in regional New South Wales (NSW), Australia. A total of 28,487 cases of blood glucose results were pooled and those with HbA1c and anaemia results were evaluated for correlation with the BGL results. Data collection was limited to de-identified information from the laboratory information system, hence details on the ethnicity and medical history were unavailable. Descriptive frequencies and Pearson correlations were performed. In the pooled data, 53.36% of individuals were females, and 50.54% had BGL ≥5.6 mmol/L. In the pilot dataset, the majority (64.86%) were males, 18.92% with BGL ≤5.6 mmol/L and 67.57% had HbA1c (≥6.5%). In the entire dataset, BGL was moderately and positively correlated with HbA1c (r = 0.6), whereas in the subset of individuals with normo-BGL and anaemia, the correlation was negative (r = -0.2). This pilot investigation observed a pertinent issue, which is a negative correlation between glycaemia and HbA1c in patients with anaemia. HbA1c was falsely increased despite normal blood glucose levels in individuals with anaemia. This advances the speculation that anaemia falsely increases HbA1c. Therefore, caution is necessary while interpreting HbA1c results for patients with anaemia, and new methods for interpretation are required.

Tingkat Kecemasan dengan Kadar Gula Darah Penderita Diabetes Mellitus Tipe II di Puskesmas Kerabitan I

The primary issue in type II diabetes mellitus is the body's inadequate reaction to insulin (insulin resistance), resulting in the inability of glucose to enter the cells. Preserving mental well-being, particularly by preventing anxiety, is a method that can be employed to address insulin resistance in individuals with diabetes. The objective of this study was to establish the correlation between anxiety levels and blood glucose levels in individuals diagnosed with Type II diabetes mellitus. The research employed a quantitative correlation methodology with a cross-sectional approach. The study consisted of a sample size of 40 respondents, and the sampling method employed was non-probability sampling using purposive sampling. The findings indicated that a significant proportion of participants, specifically 33 individuals (82.5%), reported experiencing mild anxiety and had elevated blood glucose levels. The Spearman's Rho correlation test yielded a statistically significant result (p-value = 0.017, &lt;0.05). A correlation was observed between the anxiety levels and blood sugar levels of patients diagnosed with type II diabetes mellitus at UPTD Puskesmas Kerambitan I in 2021. It is important for individuals with diabetes to prioritize their psychological well-being, particularly by avoiding anxiety as it can negatively impact blood glucose levels.

Effect of Neck-Deep Immersion in Cool or Thermoneutral Water on Blood Glucose Levels in Individuals With Type 1 Diabetes.

It is unclear whether immersion in cool water, typical of many beaches, increases the concentration of blood glucose in individuals with type 1 diabetes mellitus (T1DM). To test the hypothesis in individuals with T1DM that immersion neck-deep in cool water (COOL) causes an increase in blood glucose concentration, but not exposure to thermoneutral water (THERMO) or thermoneutral air. Eight overnight-fasted participants with T1DM were exposed for 60 minutes on separate days to 3 experimental conditions: cool water (COOL, 23 °C); thermoneutral water (THERMO, 33.5 °C); or thermoneutral air (24 °C). They then recovered for 60 minutes on land at 24 °C. At time intervals, we measured: blood glucose and plasma insulin concentration, rate of carbohydrate and fat oxidation, skin and core temperature, subcutaneous blood flow, and shivering via electromyography. There was no change in blood glucose concentration during the 3 experimental conditions (P > .05). During recovery after COOL, blood glucose increased (P < .05) but did not change in the other 2 conditions. The rate of carbohydrate oxidation during and early after COOL was higher than in the other 2 conditions (P < .05), and COOL led to a decrease in subcutaneous blood flow and the concentration of plasma insulin (P < .05). Cool or thermoneutral neck-deep immersion in water does not cause a change in the concentration of blood glucose in people with T1DM, but on-land recovery from COOL causes an increase in blood glucose that may be due, at least in part, to the accompanying decrease in plasma insulin.

Correlational analysis between salivary and blood glucose levels in individuals with and without diabetes mellitus: a cross-sectional study

Objective To estimate the association of patient-related demographic, socioeconomic status, physical activity, stress, and dietary factors influencing the relationship between salivary and blood glucose levels in individuals with and without diabetes mellitus (DM). Method This cross-sectional study was conducted on 166 participants with and without DM. Saliva and blood were collected to estimate the glucose levels. Age, gender, occupation, socioeconomic and education level, BMI, hip to waist circumference, stress, dietary pattern, lifestyle, physical activity, family history of diabetes, and type of diabetes were recorded. The association of saliva to predict blood glucose levels was analysed using Spearman Rank Correlation and how these patient-related factors influence the correlation was estimated for future machine learning models. The difference in medians for various groups was calculated using the Mann-Whitney U Test or Kruskal Wallis Test. Results Blood glucose level is not significantly correlated to salivary glucose level. However, a statistically significant difference in the median blood glucose levels for diabetic participants (median = 137) compared to healthy controls (p-value < .05) was noted. The correlation between blood and salivary glucose was more positive for higher levels of glucose (Spearman 0.4). Age, alcohol consumption, monthly wages, intake of vegetables, and socioeconomic status affect blood glucose levels. Conclusion A correlation between saliva and blood glucose levels in healthy individuals was weak. Saliva should only be used as a monitoring tool rather than a diagnostic tool and is more reliable for patients with poorly controlled diabetes mellitus.

Living in the mountains: Thermal ecology and freezing tolerance of the lizard Abronia taeniata (Squamata: Anguidae)

The impact of daily and seasonal variation in environmental temperature on lizards is important, since their physiological processes are body temperature dependent. Lizards that occupy mountainous areas must have been favoured to colonize such habitats through selection on thermal biology traits to thermoregulate effectively. Moreover, mountain lizards may be able to maintain their activity near their minimum critical temperature and even have antifreeze mechanisms. Tolerance of freezing is related to the biosynthesis of cryoprotective molecules, such as glucose, whose concentration may increase after freezing. The aims of the present work were: (1) study the thermoregulation of the viviparous lizard Abronia taeniata, and (2) determine its survival and/or tolerance to freezing. This species occurs in pine forests, pine-oak forests, and mountain mesophilic forests in areas that reach freezing temperatures. In the field, we recorded air, substrate, and body temperatures at capture time of the lizards, and registered operative temperatures at the study area. In the laboratory, we determined thermal preferences, crystallization point, and blood glucose levels of individuals before and after freezing. We found out that A. taeniata sustains activity in a wide range of temperatures, actively avoids thermally favourable microhabitats in spring, and is a moderate thermoregulator during autumn and winter. In A. taeniata, the body temperatures are tightly linked to air and substrate temperatures. Seasonality had an effect over body temperature, preferred temperatures and thermoregulatory effectiveness indices. When exposed to temperatures below zero, A. taeniata showed an increase in blood glucose levels, which aided them in surviving freezing. Taken together, our results suggest that A. taeniata may sustain activity at low environmental temperatures, due to an effective behavioural thermoregulation, and in case temperatures of its habitat go below zero, is also capable of tolerate freezing.

Gut microbiota-mediated associations of green tea and catechin intakes with glucose metabolism in individuals without type 2 diabetes mellitus: a four-season observational study with mediation analysis

This four-season observational study aimed to examine the mediating role of the gut microbiota in the associations between green tea and catechin intakes and glucose metabolism in individuals without type 2 diabetes mellitus (T2DM). In each of the 4 seasons, 85 individuals without T2DM (56 male [65.9%]; mean [standard deviation] age: 43.3 [9.4] years) provided blood samples, stool samples, 3-day weighed dietary records, and green tea samples. Catechin intake was estimated by analyzing the tea samples. Linear mixed-effects model analysis showed that green tea intake was negatively associated with fasting blood glucose and insulin levels, even after considering the seasonal variations. Of the gut microbial species associated with green tea intake, the mediation analysis revealed that Phocaeicola vulgatus mediated the association between green tea intake and fasting blood glucose levels. These findings indicate that green tea can improve glucose metabolism by decreasing the abundance of P. vulgatus that is associated with elevated blood glucose levels in individuals without T2DM.

HPLC-DAD technique for the quantification of a recently approved anti-diabetic triple combination along with two toxic official impurities: Toxicity confirmation aided by molecular docking application

BackgroundGliflozins and gliptins are two distinct groups of pharmacological drugs that reduce blood glucose levels in individuals with type II diabetes in various ways that may perform their functions harmoniously. Trijardy® tablet, which contains empagliflozin, linagliptin, and metformin, was recently approved. The scientific database does not yet have a method that is sensitive enough to quantify the aforementioned medications in the presence of metformin official toxic impurities melamine and cyanoguanidine. Molecular docking modeling was utilized in this work to further prove the toxicity of melamine.MethodsThe five analytes listed before were quantified using RP-HPLC-diode array detector and a Zorbax® C8 column (4.6 × 250 mm, 5 μm) with isocratic mobile phase composed of acetonitrile and 0.05 M potassium dihydrogen phosphate buffer, which had been treated by ?-phosphoric acid to restore a pH of 4.0 (90:10, v/v) at a flow rate of 1.2 mL/min and the eluted peaks were scanned at 250 nm.ConclusionThe utilization of the simplest isocratic elution mode give the current technique a significant time-and cost-saving benefit. The current method can quantify the triple therapy agents in the presence of each other as well as with two official toxic impurities of metformin in one short analytical run.

Effectiveness of self-management applications in improving clinical health outcomes and adherence among diabetic individuals in low and middle-income countries: a systematic review

IntroductionA variety of mobile health (mHealth) applications are available to monitor an individual’s health or lifestyle to make it convenient to access healthcare facilities at home. The usability of mHealth...

THE EFFECT OF RAMADAN FASTING AND LIFESTYLE ON DIABETIC PATIENTS IN YEMEN ENVIRONMENT

During Ramadan, Muslims who are ill or have health conditions that may deteriorate upon fasting, including patients with diabetes, are exempt. During the Ramadan fast, it is essentially a radical change in lifestyle for the period of 1 lunar month that may affect diabetic and cardiac patients. So, this study, was carried out during the period of April 2021 to May 2021(Ramadan month) in Taiz city on 64 already diagnosed diabetic patients. During fasting (stage 1), at fasting breaking (stage 2), and after 2 hours (stage 3), blood glucose level was measured by an automated analyzer. The body mass index (BMI) was calculated as BMI: weight (Kg) / height (m)2= (w/h2).Results showed statistical significant effects of test times on blood glucose level. No statistically significant effect of sex on blood glucose level with test time was recorded. The effects of age and treatment type on blood glucose level in Ramadan were observed (P=0.003, 0.042 respectively). Blood glucose levels of individuals with diabetes duration larger than 15 years have higher blood glucose levels at stages 1 and 2 (Odds ratio= 2 and 1.4 respectively). The major of the participants were healthy weight and overweight (37.5 % and 31.3 % respectively). A higher proportion of male participants was overweight (37.5%) with BMI-mean 28.08 Kg/m2 and healthy weight (35%) with BMI-mean 23.23 Kg/m2. The correlation between BMI and residual blood glucose level was statistically significant (p&lt;0.001) in stages 1, 2, and 3. There were no statistically significant relationships between BMI and blood glucose level, these findings agree with other authors. On the other hand, RMA-regression analysis and Pearson correlation emphasized the correlation between BMI and residual blood glucose level in stages 1, 2, and 3. From current study, perhaps concludes that the variations in blood glucose levels may be mainly due to lifestyle modification (diet, physical activity, and sleeping hours) during Ramadan month. So, the results of our study and the other kinds of literature indicate that fasting in Ramadan is safe for the majority of patients with diabetes management.

Zone-MPC Automated Insulin Delivery Algorithm Tuned for Pregnancy Complicated by Type 1 Diabetes.

Type 1 diabetes (T1D) increases the risk for pregnancy complications. Increased time in the pregnancy glucose target range (63-140 mg/dL as suggested by clinical guidelines) is associated with improved pregnancy outcomes that underscores the need for tight glycemic control. While closed-loop control is highly effective in regulating blood glucose levels in individuals with T1D, its use during pregnancy requires adjustments to meet the tight glycemic control and changing insulin requirements with advancing gestation. In this paper, we tailor a zone model predictive controller (zone-MPC), an optimization-based control strategy that uses model predictions, for use during pregnancy and verify its robustness in-silico through a broad range of scenarios. We customize the existing zone-MPC to satisfy pregnancy-specific glucose control objectives by having (i) lower target glycemic zones (i.e., 80-110 mg/dL daytime and 80-100 mg/dL overnight), (ii) more assertive correction bolus for hyperglycemia, and (iii) a control strategy that results in more aggressive postprandial insulin delivery to keep glucose within the target zone. The emphasis is on leveraging the flexible design of zone-MPC to obtain a controller that satisfies glycemic outcomes recommended for pregnancy based on clinical insight. To verify this pregnancy-specific zone-MPC design, we use the UVA/Padova simulator and conduct in-silico experiments on 10 subjects over 13 scenarios ranging from scenarios with ideal metabolic and treatment parameters for pregnancy to extreme scenarios with such parameters that are highly deviant from the ideal. All scenarios had three meals per day and each meal had 40 grams of carbohydrates. Across 13 scenarios, pregnancy-specific zone-MPC led to a 10.3 ± 5.3% increase in the time in pregnancy target range (baseline zone-MPC: 70.6 ± 15.0%, pregnancy-specific zone-MPC: 80.8 ± 11.3%, p < 0.001) and a 10.7 ± 4.8% reduction in the time above the target range (baseline zone-MPC: 29.0 ± 15.4%, pregnancy-specific zone-MPC: 18.3 ± 12.0, p < 0.001). There was no significant difference in the time below range between the controllers (baseline zone-MPC: 0.5 ± 1.2%, pregnancy-specific zone-MPC: 3.5 ± 1.9%, p = 0.1). The extensive simulation results show improved performance in the pregnancy target range with pregnancy-specific zone MPC, suggest robustness of the zone-MPC in tight glucose control scenarios, and emphasize the need for customized glucose control systems for pregnancy.