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Biomedical subjects

W Kerner

Publications and source records attributed to W Kerner.

98 records · Page 6Linked to original sources
PubMedDate not supplied

["Glucosensor Unitec Ulm". A portable, continuously measuring glucose sensor and monitor].

The "Glucosensor Unitec Ulm" is the first commercially available, portable glucose monitor that permits continuous measurement in venous blood under ambulatory conditions for up to 256 hours. The device weights 850 g, and measures 15 x 19 x 7 cm. Depending on the flow rate of the pump, the blood requirement is 15-25 ml/24 h. The size of the built-in-memory is 32 kByte, enough to store 3180-15,900 glucose values. The "24 hour glucogram" obtained under day to day living conditions permits the detection of disturbances of carbohydrate metabolism. Thus, early abnormalities of type II diabetes can be detected as well the degree of blood glucose normalization in patients suffering from severe insulin-dependent diabetes. Moreover, the effects of glucose-lowering drugs can be analyzed objectively. Finally, this portable glucose monitor permits the recognition of hypoglycemia induced by insulin administration or endogenous insulin overproduction due to tumors.

Blood Glucose↗
PubMedDate not supplied

[Analytic design and clinical application of an intelligent control system for pharmacotherapy with insulin--1].

To determine whether insulin dosage recommendations provided by a computer system are as effective as those given by human experts, we developed an intelligent control system and prospectively studied its use in 42 type-1 diabetics attending a diabetes education center. Control algorithms were based on blood glucose self-monitoring and included parameter estimations to determine glucose metabolism. The algorithms were implemented in a vest pocket-sized system. Over a period of 32 days, 21 patients used the computer to determine the necessary dose of insulin, while a second group of 21 patients followed the recommendations of the diabetes specialists. Baseline HbA1 levels (9.8 +/- 1.6 vs 9.9 +/- 1.6%) were identical in the two groups. The mean serum glucose over the last two weeks of the study was lower in the computer group (151.3 +/- 25.2 vs 165.7 +/- 36.0 mg/dl; p < 0.01) although the rates of hypoglycaemic episodes were equal (1.7 vs 2.3%). Metabolic control, measured by the day-to-day standard deviation of the serum glucose (46.8 +/- 14.4 vs 50.4 +/- 16.2 mg/dl; p < 0.01), was more stable in the computer group. We conclude that metabolic control and safety were comparable in the two groups, and suggest that such an intelligent control system may be of benefit for use at home, when the help of doctors or diabetes educators is not available.

Artificial Intelligence↗
PubMedDate not supplied

Comparison of the biologic activity of biosynthetic human insulin and natural pork insulin in juvenile-onset diabetic subjects assessed by the glucose controlled insulin infusion system.

To assess the biologic activity of biosynthetic human insulin (BHI) synthesized by Escherichia coli, six insulin-dependent juvenile-onset diabetic subjects were studied with BHI and natural pork insulin, by means of the glucose controlled insulin infusion system (GCIIS). First, after an overnight normalization of blood glucose levels, the 24-h insulin requirement was determined while the patients were consuming a diet of 30 kcal/kg. Then, the amount of glucose necessary to maintain normal blood glucose levels during a 5-h intravenous infusion of BHI and pork insulin, respectively, was assessed. Both studies demonstrate that in the insulin-dependent diabetic subject, BHI is at least as effective as natural pork insulin and may, therefore, be useful for the treatment of insulin-dependent diabetes mellitus.

Adolescent↗
PubMedDate not supplied

Incidence of hypoglycemic episodes in diabetic patients under continuous subcutaneous insulin infusion and intensified conventional insulin treatment: assessment by means of semiambulatory 24-hour continuous blood glucose monitoring.

The incidence and magnitude of hypoglycemia (i.e., blood glucose values less than 50 mg/dl) were assessed by continuous blood glucose monitoring over 24 h in 10 insulin-dependent diabetic (IDD) patients treated with continuous subcutaneous insulin infusion (CSII) and 9 IDD patients under intensified conventional treatment (ICT). A newly developed, battery-powered blood glucose monitor was employed. Patients were thus enabled to move freely in the hospital premises. Despite similar quality of previous blood glucose control (HbA1: 8.0 +/- 0.05% CSII versus 8.0 +/- 0.3% ICT, mean +/- SEM), the obtained profiles showed better regulation under CSII treatment (mean blood glucose [MBG], 99.6 +/- 10.0 versus 133.1 +/- 7.4 mg/dl; M-value, 12.3 +/- 3.5 versus 26.2 +/- 4.1; mean amplitude of glycemic excursion [MAGE], 71.9 +/- 8.7 versus 132.9 +/- 14.2 mg/dl; CSII versus ICT, mean +/- SEM). The incidence of blood glucose values less than 50 mg/dl was 9/10 patients (CSII) and 5/9 patients (ICT). In both groups, hypoglycemia was most frequent at noon and was related to elevated pre- and postprandial free insulin levels. Patients became aware of hypoglycemia only in 6/23 episodes (CSII) and 6/8 episodes (ICT). Our data indicate that CSII as well as ICT may result in postprandial hyperinsulinemia leading to frequent hypoglycemic episodes of variable length, reassessing the traditional experience of close correlation between aggressive insulin therapy and enhanced hypoglycemic risk.

Adolescent↗
PubMedDate not supplied

A comparison of premeal subcutaneous insulin infusion and injection in type I diabetic patients under continuous basal subcutaneous insulin delivery.

Blood glucose control under continuous subcutaneous insulin infusion (CSII) was assessed in five type I diabetic patients by measurement of mean blood glucose and M-values. These results were compared with the data obtained from treatment with constant basal subcutaneous insulin delivery supplemented by injection of regular insulin before meals into changing sites of the anterior abdominal wall. CSII treatment gave significantly (P less than 0.05) better results. It might be assumed that this is due to the more reliable insulin absorption from an unchanged site.

Adolescent↗