IMPORTANCE OF INSULIN SECRETION BASED ON THE RATE OF CHANGE IN BLOOD GLUCOSE CONCENTRATION IN GLUCOSE TOLERANCE, ASSESSED BY THE ARTIFICIAL BETA CELL

1978 ◽  
Vol 87 (2) ◽  
pp. 339-351 ◽  
Author(s):  
Ryuzo Kawamori ◽  
Motoaki Shichiri ◽  
Yoshikazu Goriya ◽  
Yoshimitsu Yamasaki ◽  
Yukio Shigeta ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Beta Cell ◽  
Glucose Concentration ◽  
Insulin Infusion ◽  
Insulin Pump ◽  
Blood Glucose Concentration ◽  
Rate Of Change ◽  
Glucose Regulation ◽  
Physiological Level ◽  
Artificial Beta Cell

ABSTRACT The dynamic property of glucose-induced insulin secretion was simulated with the aid of a control theory, and the relationship between the stepwise input of glucose concentration and the biphasic response of insulin as an output was expressed in the transfer function of proportional plus derivative action to glucose concentration. By utilizing this model, the following computer algorithm for the artificial beta cell was made; rate of insulin infusion = Kp BG + Kd ΔBG+ Kc, where BG was the abbreviation for glucose concentration, ΔBG was the rate of change in BG, Kp and Kd were the coefficient for the proportional and derivative action, respectively, and Kc the constant for basal insulin secretion. Microcomputer, insulin pump and digital printer were packed in small case, which was connected with glucose analyzer. Experiments were carried out in the depancreatized dogs to validate the importance of infused insulin based on derivative action to glucose concentration in glucose regulation. Kd/Kp ratio was changed when insulin was infused following iv glucose bolus injection. The results revealed that when the derivative action was added to the proportional action properly in insulin infusion regulatory system, insulin requirement was the smallest and glucose regulation was the best. The characteristics of the system recognized in clinical application were 1) rate of insulin infusion was small enough to keep the plasma concentration of insulin at a physiological level, then insulin requirements were reduced to around a half of those given subcutaneously, 2) glucose or glucagon to restore hypoglycaemia was not essential.

STUDY OF GLUCOSE TOLERANCE AND THE DYNAMIC PROPERTY OF INSULIN SECRETION. ANALYSIS OF INTRAVENOUS GLUCOSE TOLERANCE TEST WITH THE AID OF A CONTROL THEORY

1979 ◽  
Vol 90 (2) ◽  
pp. 283-294 ◽  
Author(s):  
Ryuzo Kawamori ◽  
Motoaki Shichiri ◽  
Teishi Murata ◽  
Makoto Nomura ◽  
Yukio Shigeta ◽  
...  
Keyword(s):  
Insulin Secretion ◽  
Blood Glucose ◽  
Glucose Tolerance ◽  
Dynamic Property ◽  
Glucose Concentration ◽  
Weighting Function ◽  
Blood Glucose Concentration ◽  
Rate Of Change ◽  
Intravenous Glucose ◽  
K Value

ABSTRACT The dynamic property of insulin secretion in relation to glucose tolerance was investigated quantitatively during iv glucose tolerance tests in 237 cases. The following results were obtained; 1) Glucose clearance constant (k-value) was not constant but variable with time and should be expressed as a function of time, K(t). In normal glucose tolerance, K(t) became greater with time. 2) Glucose-induced insulin secretion was expressed as the function of a proportional plus derivative response to glucose concentration. A weighting function of derivative response, reflecting the insulin secretion per unit of rate of change in blood glucose concentration, was calculated from blood glucose concentration (input) and insulin concentration (output) by the deconvolution method. It was clearly shown that the gain in weighting function was small and the response was slow even in the individual whose glucose tolerance was slightly impaired. 3) The greater the weighting function, the larger the change in K(t).

Neonatal hyperglycemia in a preterm infant managed with a subcutaneous insulin pump

2020 ◽  
Vol 77 (10) ◽  
pp. 739-744
Author(s):  
Julia D Muzzy Williamson ◽  
Brenda Thurlow ◽  
Mohamed W Mohamed ◽  
Dacotah Yokom ◽  
Luis Casas
Keyword(s):  
Blood Glucose ◽  
Preterm Infant ◽  
Glucose Concentration ◽  
Insulin Pump ◽  
Blood Glucose Concentration ◽  
Glucose Monitoring ◽  
Regular Insulin ◽  
Central Line ◽  
Subcutaneous Insulin ◽  
Neonatal Hyperglycemia

Abstract Purpose Successful use of a subcutaneous insulin pump to administer regular insulin to a preterm infant with neonatal hyperglycemia is described. Summary A 520-g female infant born at 23 weeks’ gestational age via caesarian section was noted to have elevated blood glucose concentrations ranging up to 180 mg/dL (in SI units, 10 mmol/L) on day of life (DOL) 3 and peaking on DOL 9 at 250 mg/dL (13.9 mmol/L) despite conservative glucose infusion rates. Continuous infusion of regular insulin was begun on DOL 8 and continued through DOL 44, with an average insulin infusion rate of 0.08 units/kg/h. The patient experienced blood glucose concentration lability due to multiple factors, resulting in the need for frequent and routine blood glucose concentration monitoring to minimize hypoglycemia events. On DOL 44, a subcutaneous insulin pump was placed and used to provide diluted regular insulin (25 units/mL). After 1 week, the patient’s blood glucose concentration normalized, which led to a reduction in the frequency of glucose monitoring. After 3 weeks, insulin pump use was discontinued. The patient remained euglycemic thereafter. Conclusion The use of an insulin pump resulted in decreased blood glucose checks, discontinuation of central line access, and overall better patient care.

scholarly journals Use of a glucose controlled insulin infusion system (artificial beta cell) to control diabetes during surgery

Diabetologia ◽  
1979 ◽  
Vol 16 (3) ◽  
pp. 157-164 ◽  
Author(s):  
S. S. Schwartz ◽  
D. L. Horwitz ◽  
B. Zehfus ◽  
B. Langer ◽  
A. R. Moossa ◽  
...  
Keyword(s):  
Beta Cell ◽  
Insulin Infusion ◽  
Artificial Beta Cell ◽  
Control Diabetes ◽  
Infusion System

scholarly journals Impaired glucose homeostasis in Shb−/− mice

2009 ◽  
Vol 203 (2) ◽  
pp. 271-279 ◽  
Author(s):  
Björn Åkerblom ◽  
Sebastian Barg ◽  
Gabriela Calounova ◽  
Dariush Mokhtari ◽  
Leif Jansson ◽  
...  
Keyword(s):  
Gene Expression ◽  
Insulin Secretion ◽  
Blood Glucose ◽  
Endothelial Cell ◽  
Glucose Homeostasis ◽  
Glucose Concentration ◽  
Cell Function ◽  
Blood Glucose Concentration ◽  
Β Cell ◽  
Islet Volume

Src homology 2 domain-containing protein B (SHB) is an adapter protein involved in the regulation of β-cell and endothelial cell function. We have recently obtained the Shb knockout mouse, and consequently, the aim of this study was to assess the effect of Shb deletion upon β-cell function and blood glucose homeostasis. Shb−/− mice display an elevated basal blood glucose concentration, and this increase is maintained during insulin challenge in insulin sensitivity tests. To assess glucose-induced insulin secretion, pancreata were perfused, and it was observed that Shb−/− first phase insulin secretion was blunted during glucose stimulation. Gene expression of Shb−/− islets shortly after isolation was altered, with increased pancreatic and duodenal homeobox gene-1 (Pdx1) gene expression and reduced expression of Vegf-A. Islet culture normalized Pdx1 gene expression. The microvascular density of the Shb−/− islets was reduced, and islet capillary endothelial cell morphology was changed suggesting an altered microvascular function as a contributing cause to the impaired secretory activity. Capacitance measurements of depolarization-induced exocytosis indicate a direct effect on the exocytotic machinery, in particular a dramatic reduction in readily releasable granules, as responsible for the insulin-secretory defect operating in Shb−/− islets. Shb−/− mice exhibited no alteration of islet volume or β-cell area. In conclusion, loss of Shb impairs insulin secretion, alters islet microvascular morphology, and increases the basal blood glucose concentration. The impaired insulin secretory response is a plausible underlying cause of the metabolic impairment observed in this mutant mouse.

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