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Blood Glucose Self-Monitoring↗
Biomedical subjects
P S Strumph
Publications and source records attributed to P S Strumph.
The accuracy of blood glucose testing by children.
While studies have evaluated the accuracy of adult patients and health personnel in reading various glucose oxidase impregnated strips to estimate blood glucose, there are no studies exclusively evaluating the accuracy of children with diabetes reading their own strips as compared to a staff member, and meter to meter variability in reading these strips. We evaluated the accuracy of reading chemstrip bG by children at a summer camp. The children's visual readings of their own strips were compared to the visual reading of a single staff member. A total of 356 Chemstrip bG's were visually read by diabetic children and a single trained staff member at a summer camp for diabetics. The strips were then analyzed by two Accu-Chek bG meters. Intermachine variability was found to be negligible over the entire bG range. For the purposes of this study, we define accurate visual readings as those within +/- 15 percent of the meter reading of a given strip. At low bG values (40-79 mg/dl), accuracy by children and staff is low, with underestimating occurring in 39 percent of staff readings and 57 percent of children's readings. At intermediate bG values (120-239 mg/dl) readings are more accurate, especially when read by the staff, with misreadings occurring in only 16-19 percent of the strips. At high bG values (240-399 mg/dl), accuracy by children is decreased, with underestimation 500 percent more often than staff. We conclude that children are less accurate at reading Chemstrip bG than a trained staff member (51% versus 33% misreading), especially at the upper and lower ranges of bG values when visual readings are least accurate, and the need for therapeutic intervention is the greatest.
Adolescent↗
Insulin effects on apolipoprotein B lipoprotein synthesis and secretion by primary cultures of rat hepatocytes.
Lipoprotein synthesis and secretion were examined in primary cultures of rat hepatocytes cultured on collagen-coated plates and incubated with pharmacologic and physiologic concentrations of insulin. Media insulin concentration declined rapidly over the course of incubation indicating that hepatocytes rapidly degrade insulin. When insulin was present in the media, cellular triglyceride accumulated while lipid secretion declined. Insulin inhibited the incorporation of labeled amino acids into total secretory lipoprotein apoproteins and apolipoprotein B (apo B) as well as apo B mass as measured by monoclonal radioimmunoassay. The effect of insulin on apo B secretion occurred as early as three hours after the addition of insulin to the culture media and both apo B of higher molecular weight (apo BH) and apo B of lower molecular weight (apo BL) were affected. Cellular apo B did not accumulate within cells. The majority of secretory lipid radioactivity synthesized from acetate was in VLDL density lipoproteins. The composition of newly synthesized lipids as assessed by thin layer chromatography was not significantly altered with insulin. These studies support the finding that insulin inhibits VLDL secretion by hepatocytes while at the same time stimulating overall triglyceride synthesis. A suggested mechanism is that insulin uncouples triglyceride and apo B synthesis, which influences subsequent lipoprotein assembly and secretory pathways. These results are consistent with the concept that postprandial insulin release inhibits hepatic lipoprotein secretion while intestinal lipoprotein metabolic pathways are most active.
Acetates↗