Blood glucose control by intermittent loop closure in the basal mode: computer simulation studies with a diabetic model.

Abstract:

:A semiclosed loop, bedside insulin infusion system using a simple basal infusion algorithm consisting of a linear transition between two insulin delivery rates as blood glucose (BG) increases has been developed. A theoretical study using computer simulation has now been undertaken to examine the effect of BG sampling frequency and algorithm parameters on BG control. A model for BG control by exogenous insulin in the individual with diabetes was developed from a model for healthy subjects and from clinical data in the literature. Results of computer simulation using this model showed a decrease in BG stability as the sampling interval increased from 1 to 4 h. Simulations also showed a decrease in BG stability as the sensitivity of the control algorithm increased. Choice of an appropriate basal control algorithm involved a compromise between stability, sampling interval, and metabolic control. We conclude that satisfactory metabolic control can be obtained using intermittent BG sampling in the basal state; sampling at intervals of 3 h combined with a basal control algorithm whereby insulin delivery rate increases linearly from 0.5 to 2.5 U/h over the BG range 2-12 mmol/L appears suitable for most diabetic persons. Three-hour sampling offers a good compromise between degree of metabolic control and clinical effort involved.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Furler SM,Kraegen EW,Smallwood RH,Chisholm DJ

doi

10.2337/diacare.8.6.553

subject

Has Abstract

pub_date

1985-11-01 00:00:00

pages

553-61

issue

6

eissn

0149-5992

issn

1935-5548

journal_volume

8

pub_type

杂志文章
  • Fetal hemoglobin in diabetic patients.

    abstract:OBJECTIVE:To determine the occurrence of elevated fetal hemoglobin (HbF) among the diabetic population and determine the clinical situation of importance. RESEARCH DESIGN AND METHODS:A cross-sectional study was conducted. HbA1c and HbF were measured with high-performance liquid chromatography in 1,104 consecutive diab...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章

    doi:10.2337/diacare.17.8.828

    authors: Koskinen LK,Lahtela JT,Koivula TA

    更新日期:1994-08-01 00:00:00

  • Metabolic control in adolescent girls: links to relationality and the female sense of self.

    abstract:OBJECTIVE:This study investigated whether intimacy and autonomy in mother-daughter interactions and relational aspects of the self are associated with metabolic control in adolescent girls with type 1 diabetes. RESEARCH DESIGN AND METHODS:This cross-sectional study included 88 girls with diabetes (mean age 14.9 +/- 2....

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.27.3.709

    authors: Maharaj S,Daneman D,Olmsted M,Rodin G

    更新日期:2004-03-01 00:00:00

  • Why do low-fat high-carbohydrate diets accentuate postprandial lipemia in patients with NIDDM?

    abstract:OBJECTIVE:To understand why low-fat high-carbohydrate (CHO) diets lead to higher fasting and postprandial concentrations of triglyceride (TG)-rich lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS:Patients with NIDDM were placed randomly on diets containing eith...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.18.1.10

    authors: Chen YD,Coulston AM,Zhou MY,Hollenbeck CB,Reaven GM

    更新日期:1995-01-01 00:00:00

  • Changes in diabetes self-care behaviors make a difference in glycemic control: the Diabetes Stages of Change (DiSC) study.

    abstract:OBJECTIVE:This study compared diabetes Treatment As Usual (TAU) with Pathways To Change (PTC), an intervention developed from the Transtheoretical Model of Change (TTM), to determine whether the PTC intervention would result in greater readiness to change, greater increases in self-care, and improved diabetes control. ...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.26.3.732

    authors: Jones H,Edwards L,Vallis TM,Ruggiero L,Rossi SR,Rossi JS,Greene G,Prochaska JO,Zinman B,Diabetes Stages of Change (DiSC) Study.

    更新日期:2003-03-01 00:00:00

  • Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study.

    abstract:OBJECTIVE:We examined the effects of metformin on diabetes prevention and the subgroups that benefited most over 15 years in the Diabetes Prevention Program (DPP) and its follow-up, the Diabetes Prevention Program Outcomes Study (DPPOS). RESEARCH DESIGN AND METHODS:During the DPP (1996-2001), adults at high risk of de...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc18-1970

    authors: Diabetes Prevention Program Research Group.

    更新日期:2019-04-01 00:00:00

  • Insulin concentrations and time-action profiles of three different intermediate-acting insulin preparations in nondiabetic volunteers under glucose-controlled glucose infusion technique.

    abstract::This study describes the pharmacokinetics of three intermediate-acting insulin preparations, NPH porcine insulin, NPH human insulin (recombinant DNA), and "Depot-A" insulin, a mixture of 20% regular and 80% NPH human insulin from Eli Lilly and Company. Metabolic healthy normal weight volunteers were selected for the s...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.5.2.s43

    authors: Bottermann P,Gyaram H,Wahl K,Ermler R,Lebender A

    更新日期:1982-11-01 00:00:00

  • Impact of degree of obesity on surrogate estimates of insulin resistance.

    abstract:OBJECTIVE:To evaluate the role of adiposity in the relationship between specific and surrogate estimates of insulin-mediated glucose uptake (IMGU) in a large nondiabetic population. RESEARCH DESIGN AND METHODS:Healthy volunteers were classified by BMI into normal weight (<25.0 kg/m(2), n = 208), overweight (25.0-29.9 ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.27.8.1998

    authors: Kim SH,Abbasi F,Reaven GM

    更新日期:2004-08-01 00:00:00

  • Risk factors for frequent and severe hypoglycemia in type 1 diabetes.

    abstract:OBJECTIVE:To determine the risk of frequent and severe hypoglycemia and the associated demographic and clinical risk factors. RESEARCH DESIGN AND METHODS:Demographic and diabetes self-management factors were measured in 415 subjects followed prospectively for 4-6.5 years of type 1 diabetes duration as participants in ...

    journal_title:Diabetes care

    pub_type: 杂志文章,多中心研究

    doi:10.2337/diacare.24.11.1878

    authors: Allen C,LeCaire T,Palta M,Daniels K,Meredith M,D'Alessio DJ,Wisconsin Diabetes Registry Project.

    更新日期:2001-11-01 00:00:00

  • Psychosocial crisis in diabetic renal failure.

    abstract::Twenty-nine diabetic renal failure patients suffered a psychosocial crisis at the time when chronic dialysis or renal transplantation was required. These patients could be classified into groups as to the impact of the crisis in terms of participation in life-support therapy. Group 1 consisted of potentially lethal me...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.4.1.99

    authors: D'Elia JA,Piening S,Kaldany A,Malarick C,Unger K,Ice S,Anderson RB,Miller DG,Lundin AP

    更新日期:1981-01-01 00:00:00

  • Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S.

    abstract:OBJECTIVE:The International Diabetes Federation (IDF) has proposed a new definition of the metabolic syndrome that emphasizes central adiposity as determined by ethnic group-specific thresholds of waist circumference. The objective of this study was to estimate the prevalence of this syndrome using the IDF definition a...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.28.11.2745

    authors: Ford ES

    更新日期:2005-11-01 00:00:00

  • Receiver operating characteristic analysis of HLA, CTLA4, and insulin genotypes for type 1 diabetes.

    abstract:OBJECTIVE:This study assessed the ability to distinguish between type 1 diabetes-affected individuals and their unaffected relatives using HLA and single nucleotide polymorphism (SNP) genotypes. RESEARCH DESIGN AND METHODS:Eight models, ranging from only the high-risk DR3/DR4 genotype to all significantly associated H...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc12-2284

    authors: Valdes AM,Varney MD,Erlich HA,Noble JA

    更新日期:2013-09-01 00:00:00

  • Acute actions of sulfonylurea drugs during long-term treatment of NIDDM.

    abstract::The acute effect of sulfonylurea drugs during long-term treatment was evaluated in two separate studies. In the first study, the levels of plasma glucose, insulin, and C-peptide were measured after intake of 10 mg glyburide alone or together with a standardized mixed meal in 10 non-insulin-dependent diabetes mellitus ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.13.3.26

    authors: Faber OK,Beck-Nielsen H,Binder C,Butzer P,Damsgaard EM,Froland F,Hjollund E,Lindskov HO,Melander A,Pedersen O

    更新日期:1990-08-01 00:00:00

  • Improvement of glycemic control in subjects with poorly controlled type 2 diabetes: comparison of two treatment algorithms using insulin glargine.

    abstract:OBJECTIVE:Large prospective studies have demonstrated that optimum glycemic control is not routinely achieved in clinical practice. Barriers to optimal insulin therapy include hypoglycemia, weight gain, and suboptimal initiation and dose titration. This study compared two treatment algorithms for insulin glargine initi...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2337/diacare.28.6.1282

    authors: Davies M,Storms F,Shutler S,Bianchi-Biscay M,Gomis R,ATLANTUS Study Group.

    更新日期:2005-06-01 00:00:00

  • Metabolic consequences of hepatic steatosis in overweight and obese adolescents.

    abstract:OBJECTIVE:To test the hypothesis that hepatic steatosis is associated with risk factors for type 2 diabetes in overweight and obese youth, mediated by cardiorespiratory fitness. RESEARCH DESIGN AND METHODS:This was a cross-sectional study comparing insulin sensitivity between 30 overweight and obese adolescents with h...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-1754

    authors: Wicklow BA,Wittmeier KD,MacIntosh AC,Sellers EA,Ryner L,Serrai H,Dean HJ,McGavock JM

    更新日期:2012-04-01 00:00:00

  • Secular trends in treatment and control of type 2 diabetes in an American Indian population: a 30-year longitudinal study.

    abstract:OBJECTIVE:Treatment guidelines for diabetes have become increasingly stringent as most research shows that more aggressive intervention reduces the risks for complications. Community data on the effect of these interventions are lacking. RESEARCH DESIGN AND METHODS:Changes in the pharmacologic treatment of diabetes, b...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc10-0678

    authors: Looker HC,Krakoff J,Andre V,Kobus K,Nelson RG,Knowler WC,Hanson RL

    更新日期:2010-11-01 00:00:00

  • Significant synergistic effect of peroxisome proliferator-activated receptor gamma C-2821T and diabetes on the risk of ischemic stroke.

    abstract:OBJECTIVE:To explore the relationship between the genetic polymorphisms of PPARgamma (Pro12Ala, C1431T, and C-2821T) and the risk of ischemic stroke and to investigate whether these genetic polymorphisms of PPARgamma would modify the risk of ischemic stroke among patients with hypertension or diabetes. RESEARCH DESIGN...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-0717

    authors: Hsieh FI,Lo WC,Lin HJ,Hsieh YC,Lien LM,Bai CH,Tseng HP,Chiou HY

    更新日期:2009-11-01 00:00:00

  • Carotid atherosclerosis and serum lipoprotein(a) concentrations in patients with NIDDM.

    abstract:OBJECTIVE:To investigate the association of carotid atherosclerosis and serum lipoprotein(a) [Lp(a)] concentrations in subjects with NIDDM. RESEARCH DESIGN AND METHODS:We measured carotid intima-media thickness (IMT) and Lp(a) concentrations in 117 NIDDM subjects. Subjects were divided into tertiles according to IMT v...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.5.829

    authors: Yamamoto M,Egusa G,Yamakido M

    更新日期:1997-05-01 00:00:00

  • Prediction of diabetes based on baseline metabolic characteristics in individuals at high risk.

    abstract:OBJECTIVE:Individuals with impaired glucose tolerance (IGT) are at high risk for developing type 2 diabetes mellitus (T2DM). We examined which characteristics at baseline predicted the development of T2DM versus maintenance of IGT or conversion to normal glucose tolerance. RESEARCH DESIGN AND METHODS:We studied 228 su...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-0520

    authors: Defronzo RA,Tripathy D,Schwenke DC,Banerji M,Bray GA,Buchanan TA,Clement SC,Henry RR,Kitabchi AE,Mudaliar S,Ratner RE,Stentz FB,Musi N,Reaven PD,Gastaldelli A,ACT NOW Study.

    更新日期:2013-11-01 00:00:00

  • A 1-year multicenter randomized double-blind comparison of repaglinide and glyburide for the treatment of type 2 diabetes. Dutch and German Repaglinide Study Group.

    abstract:OBJECTIVE:Repaglinide is a newly developed oral blood glucose-lowering agent that exerts its effect by stimulating insulin secretion. This multicenter study was designed to compare the efficacy and safety of this drug with glyburide in a 1-year randomized double-blind study of outpatients with type 2 diabetes. RESEARC...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.2337/diacare.22.3.463

    authors: Wolffenbuttel BH,Landgraf R

    更新日期:1999-03-01 00:00:00

  • Diabetic Neuropathy Is a Substantial Burden in People With Type 1 Diabetes and Is Strongly Associated With Socioeconomic Disadvantage: A Population-Representative Study From Scotland.

    abstract:OBJECTIVE:To assess the contemporaneous prevalence of diabetic peripheral neuropathy (DPN) in people with type 1 diabetes (T1D) in Scotland and study its cross-sectional association with risk factors and other diabetic complications. RESEARCH DESIGN AND METHODS:We analyzed data from a large representative sample of ad...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc19-1582

    authors: Jeyam A,McGurnaghan SJ,Blackbourn LAK,McKnight JM,Green F,Collier A,McKeigue PM,Colhoun HM,SDRNT1BIO Investigators.

    更新日期:2020-04-01 00:00:00

  • The independent contributions of diabetic neuropathy and vasculopathy in foot ulceration. How great are the risks?

    abstract:OBJECTIVE:To describe the relative contributions of neurological and vascular abnormalities to the overall risk of diabetic foot ulceration. RESEARCH DESIGN AND METHODS:A case-control study of diabetic veterans from the Seattle Veterans Affairs Medical Center was conducted using data collected from 46 patients with di...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.18.2.216

    authors: McNeely MJ,Boyko EJ,Ahroni JH,Stensel VL,Reiber GE,Smith DG,Pecoraro RF

    更新日期:1995-02-01 00:00:00

  • Changes in inflammatory cytokines are related to impaired glucose tolerance in offspring of type 2 diabetic subjects.

    abstract:OBJECTIVE:We sought to determine whether levels of inflammatory markers and different cytokines are abnormal in nondiabetic offspring of type 2 diabetic subjects. RESEARCH DESIGN AND METHODS:Cytokine levels were measured in 19 healthy control subjects and 129 offspring of patients with type 2 diabetes (109 with normal...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc06-0147

    authors: Ruotsalainen E,Salmenniemi U,Vauhkonen I,Pihlajamäki J,Punnonen K,Kainulainen S,Laakso M

    更新日期:2006-12-01 00:00:00

  • Low-dose bedtime NPH insulin in treatment of secondary failure to glyburide.

    abstract::Secondary failure to oral hypoglycemic agents (OHAs) is a possible outcome for non-insulin-dependent diabetes mellitus (NIDDM) patients and poses a serious therapeutic problem. In this study, we evaluated the effect of adding a single bedtime low-dose NPH insulin injection to the previous ineffective sulfonylurea ther...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.12.8.582

    authors: Trischitta V,Italia S,Borzi V,Tribulato A,Mazzarino S,Squatrito S,Vigneri R

    更新日期:1989-09-01 00:00:00

  • Oral disposition index predicts the development of future diabetes above and beyond fasting and 2-h glucose levels.

    abstract:OBJECTIVE:We sought to determine whether an oral disposition index (DI(O)) predicts the development of diabetes over a 10-year period. First, we assessed the validity of the DI(O) by demonstrating that a hyperbolic relationship exists between oral indexes of insulin sensitivity and beta-cell function. RESEARCH DESIGN ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-1478

    authors: Utzschneider KM,Prigeon RL,Faulenbach MV,Tong J,Carr DB,Boyko EJ,Leonetti DL,McNeely MJ,Fujimoto WY,Kahn SE

    更新日期:2009-02-01 00:00:00

  • Detection of microalbuminuria. Receiver operating characteristic curve analysis favors albumin-to-creatinine ratio over albumin concentration.

    abstract:OBJECTIVE:To compare albumin-to-creatinine ratio (ACR) and albumin concentration (ALB) for detection of microalbuminuria using precise data on CIs for sensitivity and specificity and to determine sex- and age-specific discriminator values for ACR. RESEARCH DESIGN AND METHODS:All consecutive patients investigated for t...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.22.2.307

    authors: Bakker AJ

    更新日期:1999-02-01 00:00:00

  • Markedly Decreasing Incidence of Blindness in People With and Without Diabetes in Southern Germany.

    abstract:OBJECTIVE:Studies comparing the incidence of blindness in persons with and without diabetes are scarce worldwide. In Germany, a decline in the incidence of blindness was found during the 1990s. The aim of this study was to analyze the recent time trend. RESEARCH DESIGN AND METHODS:Data were based on administrative fil...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-2031

    authors: Claessen H,Kvitkina T,Narres M,Trautner C,Zöllner I,Bertram B,Icks A

    更新日期:2018-03-01 00:00:00

  • Severe hypoglycemia and cognitive decline in older people with type 2 diabetes: the Edinburgh type 2 diabetes study.

    abstract:OBJECTIVE:People with type 2 diabetes are at increased risk of age-related cognitive decline and dementia. Hypoglycemia is a candidate risk factor, but the direction of association between episodes of severe hypoglycemia and cognitive decline in type 2 diabetes remains uncertain. RESEARCH DESIGN AND METHODS:In the Edi...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc13-1384

    authors: Feinkohl I,Aung PP,Keller M,Robertson CM,Morling JR,McLachlan S,Deary IJ,Frier BM,Strachan MW,Price JF,Edinburgh Type 2 Diabetes Study (ET2DS) Investigators.

    更新日期:2014-02-01 00:00:00

  • Impaired glucose tolerance and diabetes mellitus in elderly subjects.

    abstract::In a 10-yr prospective population study 406 subjects who were 70 yr old received an oral glucose tolerance test. Of these subjects 169 were retested at 80. Three sets of diagnostic criteria were evaluated, of which the WHO criteria are recommended for screening studies in this age group. The prevalences of diabetes me...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.5.6.600

    authors: Agner E,Thorsteinsson B,Eriksen M

    更新日期:1982-11-01 00:00:00

  • Cancer arising after pancreas and/or kidney transplantation in a series of 99 diabetic patients.

    abstract:OBJECTIVE:Recipients of solid organ transplants have an increased risk of developing certain types of malignancies as compared with the general population. The majority of the literature has reported on neoplasms in kidney and heart transplant recipients. RESEARCH DESIGN AND METHODS:We describe 9 neoplasms occurring i...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.20.3.272

    authors: Martinenghi S,Dell'Antonio G,Secchi A,Di Carlo V,Pozza G

    更新日期:1997-03-01 00:00:00

  • Dietary fat intake and cognitive decline in women with type 2 diabetes.

    abstract:OBJECTIVE:Individuals with type 2 diabetes have high risk of late-life cognitive impairment, yet little is known about strategies to modify risk. Targeting insulin resistance and vascular complications-both associated with cognitive decline-may be a productive approach. We investigated whether dietary fat, which modula...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-1741

    authors: Devore EE,Stampfer MJ,Breteler MM,Rosner B,Kang JH,Okereke O,Hu FB,Grodstein F

    更新日期:2009-04-01 00:00:00