Biomedical subjects

A Schiffrin

Publications and source records attributed to A Schiffrin.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Evaluation of two methods of self blood glucose monitoring by trained insulin-dependent diabetic adolescents outside the hospital.

We studied the accuracy of the Chemstrip bG and Glucometer systems in the self-monitoring of blood glucose by trained adolescents. The determinations were done at home with simultaneous collection of whole blood into capillary tubes (Sarstedt) which were later analyzed by a glucose-oxidase analyzer (Beckman Instruments). In both cases, there was an excellent correlation between laboratory concentrations and Chemstrip bG (r = 0.96, P less than 0.001) and Glucometer (r = 0.96, P less than 0.001). Comparisons made at 8 mo remained with the same degree of accuracy. There was a trend toward greater deviation with higher plasma glucose values. Well-trained patients can achieve sufficient accuracy to permit the use of either of the methods tested with similar results.

Adolescent↗

PubMedDate not supplied

Metabolic response to fasting exercise in adolescent insulin-dependent diabetic subjects treated with continuous subcutaneous insulin infusion and intensive conventional therapy.

The metabolic effects of moderate exercise in the fasting state were examined in 12 insulin-dependent diabetic adolescents treated with continuous subcutaneous insulin infusion (CSII) or intensive conventional therapy (ICT). Six patients received their usual afternoon dose the evening before the study and six received their usual infusion rate during exercise. Insulin was injected subcutaneously in the abdominal wall. Exercise was performed on a bicycle ergometer for 45 min at 50% maximum oxygen consumption. Resting plasma glucose values during both CSII (114 +/- 18 mg/dl, P less than 0.02) and ICT (136 +/- 30 mg/dl, P less than 0.01) were higher than normal (77 +/- 11 mg/dl). Diabetic patients receiving CSII showed a sharp decrease in glycemia after 45 min of exercise (77 +/- 18 mg/dl, P less than 0.02). In contrast, in patients receiving ICT and in control subjects plasma glucose did not change during exercise or recovery. Insulin levels decreased significantly during exercise in the control subjects while there was no change in plasma free insulin levels during exercise in the diabetic subjects. Profiles of intermediary metabolites in response to exercise were similar in all groups with no significant differences in resting values between diabetic subjects and controls. Continuous subcutaneous insulin infusion provides near-normoglycemia in the insulin-dependent diabetic adolescent. However, with the basal insulin infusion rate necessary to achieve near-normal fasting blood glucose levels, moderate exercise in the postabsorptive state may result in hypoglycemia with CSII.

3-Hydroxybutyric Acid↗

PubMedDate not supplied

Accommodating planned exercise in type I diabetic patients on intensive treatment.

To achieve optimal metabolic control in type I diabetic patients treated with continuous subcutaneous insulin infusion (CSII) and multiple subcutaneous injections of insulin (MSI) appropriate adjustments of the insulin prescription should be made for exercise, which is a normal component of everyday life. The present study describes the responses of seven type I diabetic adolescents treated with CSII and six patients treated with MSI to specific insulin dose changes in anticipation of postprandial exercise. The effect of 45 min of cycle ergometer exercise at 55% VO2 on glucose regulation was studied 2 h after morning insulin and a breakfast meal. To quantify the potential benefit of modifying the insulin dose before exercise, the subjects were studied on five different days in a random order: resting control day, postprandial exercise preceded by the usual dose of insulin, postprandial exercise preceded by one-half of the usual dose of insulin, postprandial exercise preceded by two-thirds of the usual dose of insulin, and postprandial exercise without the usual dose of insulin. In all cases insulin was injected or infused subcutaneously in the anterior abdominal wall. When exercise was performed without changing the usual insulin dose, there was a significant fall in glycemia in both groups, with the nadir occurring after 45 min. In the CSII group, the +/- SEM plasma glucose was 57 +/- 5 mg/dl (P less than 0.05 versus rest) with hypoglycemia occurring in four patients. In the MSI group, the mean +/- SEM plasma glucose fell to 65 +/- 10 mg/dl (P less than 0.05 versus rest) and hypoglycemia occurred in three patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Computer-assisted insulin dosage adjustment.

We report our first experience with a new microprocessor device for assisting individuals with diabetes in the adjustment of insulin therapy. The computer weighs 200 g and can receive, store, and analyze patient-entered capillary blood glucose (CBG) data on an ongoing basis. Changes in the injected mixtures of short- and intermediate-acting insulins are recommended according to algorithms designed to bring the premeal CBG levels to any desired target value set by the physician. Throughout the present study, the premeal target glucose level was set to 110 mg/dl. Seven (type I) insulin-dependent diabetic individuals ranging in age from 11 to 43 yr were selected to participate in the first use of a BCMC (Better Control Medical Computers, Inc., Toronto, Ontario, Canada) computer on an outpatient basis. All subjects were concerned about diabetes control and were fully informed about as well as thoroughly practiced in the use of manual insulin dosage adjustment schemes, based on approximately equal to 4 times daily CBG estimation, as currently taught in our diabetes clinics. During the last 7 days of the control period of self-adjustment, their mean +/- SEM CBG levels (measured before breakfast, lunch, dinner, and bedtime snack) were, respectively, 178 +/- 20, 187 +/- 35, 208 +/- 22, and 207 +/- 13 mg/dl. Immediately after the control period they were given the device and were instructed in the procedure for entering glycemic data and following manufacturer's recommendations in regard to insulin dosages. This experimental period lasted 8 wk and the outcome was assessed as before. Thus, 8 wk after starting daily use of the instrument, all glycemic values measured as before had fallen significantly (P less than 0.005-0.05) closer to normal: 116 +/- 9, 110 +/- 6, 148 +/- 15, and 135 +/- 9 mg/dl, respectively. Concurrently there was also a significant (P less than 0.01) reduction in the variability of glycemia measured before the main meals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗