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Interstitial Glucose (interstitial + glucose)
Selected AbstractsInterstitial glucose in skeletal muscle of diabetic patients during an oral glucose tolerance testDIABETIC MEDICINE, Issue 1 2005M. Frossard Abstract Aim The presence of a transcapillary arterial,interstitial gradient for glucose (AIGglu) in skeletal muscle may be interpreted as a consequence of intact cellular glucose uptake. We hypothesized that the AIGglu decreases in Type 2 diabetes mellitus as a consequence of insulin resistance, whereas it remains intact in Type 1 diabetes. Methods Glucose concentrations were measured in serum and interstitial space fluid of skeletal muscle during an oral glucose tolerance test (OGTT) in patients with Type 1 and Type 2 diabetes and in young and middle-aged healthy volunteers, using microdialysis. Results The area under the curve for glucose in serum (AUCSE) was higher than in interstitial space fluid of skeletal muscle (AUCMU) in healthy young (AUCSE = 1147 ± 332 vs. AUCMU = 633 ± 257 mM/min/ml; P = 0.006), healthy middle-aged volunteers (AUCSE = 1406 ± 186 vs. AUCMU = 1048 ± 229 mM/min/ml; P = 0.001) and in Type 1 diabetic patients (AUCSE = 2273 ± 486 vs. AUCMU = 1655 ± 178 mM/min/ml; P = 0.003). In contrast, in Type 2 diabetic patients AUCSE (2908 ± 1023 mM/min/ml) was not significantly different from AUCMU (2610 ± 722 mM/min/ml; P = NS). Conclusion The present data indicate that AIGglu is compromised in Type 2 diabetes in contrast to Type 1 diabetes where it appears to be normal. Because no changes in muscle blood flow were detected, insulin resistance appears to be the main cause for the observed decreased AIGglu in skeletal muscle in Type 2 diabetic patients. [source] Manipulation of glycemic response with isomaltulose in a milk-based drink does not affect cognitive performance in healthy adultsMOLECULAR NUTRITION & FOOD RESEARCH (FORMERLY NAHRUNG/FOOD), Issue 4 2010Louise Dye Abstract Previous research suggests that glucoregulation and nutrient interventions, which alter circulating glucose, impact cognitive function. To examine the effect of modulating glycemic response using isomaltulose on cognitive function 24 healthy male adult participants consumed energy and macronutrient-matched milk-based drinks containing 50,g isomaltulose, 50,g sucrose or a water control in a counterbalanced within-subject design. Interstitial glucose was measured continuously in 12 subjects and all provided 9 capillary measures on each test day. A 30-min cognitive test battery was administered before and twice (+35 and +115,min) after drink ingestion. Immediate, delayed, recognition, verbal and working memory, and psychomotor performance were assessed. Glycemic profiles induced by the drinks differed significantly during the first but not the second post-drink test battery. Neither administration of the sucrose nor isomaltulose drinks produced consistent effects on verbal or working memory, or psychomotor performance. This study used isomaltulose as an investigative tool to lower glycemic response. Importantly, it demonstrates a lack of effect of modulating glucose on cognitive performance based on reliable, continuously measured glycemia. It refutes the hypothesis that glycemia is associated with cognitive performance and questions the suggestion that isomaltulose has an effect on cognitive performance. [source] Assessment of different techniques for subcutaneous glucose monitoring in Type 1 diabetic patients during ,real-life' glucose excursionsDIABETIC MEDICINE, Issue 3 2010J. K. Mader Diabet. Med. 27, 332,338 (2010) Abstract Aims, To compare the accuracy of two marketed subcutaneous glucose monitoring devices (Guardian RT, GRT; GlucoDay S, GDS) and standard microdialysis (CMA60; MD) in Type 1 diabetic patients. Methods, Seven male Type diabetic patients were investigated over a period of 26 h simulating real-life meal glucose excursions. Catheters of the three systems were inserted into subcutaneous adipose tissue of the abdominal region. For MD, interstitial fluid was sampled at 30- to 60-min intervals for offline glucose determination. Reference samples were taken at 15- to 60-min intervals. All three systems were prospectively calibrated to reference. Median differences, median absolute relative differences (MARD), median absolute differences (MAD), Bland,Altman plot and Clark Error Grid were used to determine accuracy. Results, Bland,Altman analysis indicated a mean glucose difference (2 standard deviations) between reference and interstitial glucose of ,10.5 (41.8) % for GRT, 20.2 (55.9) % for GDS and 6.5 (35.2) % for MD, respectively. Overall MAD (interquartile range) was 1.07 (0.39; 2.04) mmol/l for GRT, 1.59 (0.54; 3.08) mmol/l for GDS and 0.76 (0.26; 1.58) mmol/l for MD. Overall MARD was 15.0 (5.6; 23.4) % (GRT), 19.7 (6.1; 37.6) % (GDS) and 8.7 (4.1; 18.3) % (MD), respectively. Total sensor failure occurred in two subjects using GRT and one subject using GDS. Conclusions, The three investigated technologies had comparable performance. Whereas GRT underestimated actual blood glucose, GDS and MD overestimated blood glucose. Considerable deviations during daily life meal glucose excursions from reference glucose were observed for all three investigated technologies. Present technologies may require further improvement until individual data can lead to direct and automated generation of therapeutic advice in diabetes management. [source] Continuous glucose monitoring system: an attractive support tool in diabetes educationEUROPEAN DIABETES NURSING, Issue 1 2005L Saez-de-Ibarra BSc Diabetes Specialist Nurse Abstract The study was designed to determine the usefulness of the CGMS (continuous glucose monitoring system) as a support tool in type 1 diabetes education. The CGMS is a sensor system that measures interstitial glucose levels every five minutes for three or more days, by means of a microelectrode inserted in the subcutaneous tissue. People with type 1 diabetes (n=52), who actively participated in diabetes self-management programmes, were monitored with CGMS during three to five days. Patients were selected for CGMS when unsatisfied with the glycaemic results achieved, given the effort made. Ten patients used CSII, 14 used insulin glargine plus rapid acting insulin analogue and 28 used NPH insulin plus short acting insulin. All patients used blood glucose self-monitoring, with a mean of 6.5±1.4 glucose readings per day. The CGMS register was evaluated with the patient. Mean capillary glucose during the 15 days prior to CGMS, mean capillary glucose during CGMS and mean capillary glucose during the 15 days after CGMS are compared. Discussion of the record with the patient frequently allowed detection of inappropriate solving attitudes. Mean capillary glucose dropped from 155±20mg/dL (8.60±1.11mmol/L) prior to CGMS to 143±20mg/dL (7.94±1.11mmol/L) after CGMS (p=0.000). The effectiveness of CGMS (number of patients in whom mean glucose improved) rose from 66.7% in 2001 to 70.6% in 2002, 78.9% in 2003 and 88.8% in 2004. When the patient is involved in the analysis of glucose fluctuations, CGMS is a useful tool in diabetes education that will help achieve attitude changes because of the evidence depicted by the continuous glucose record. Experience in the use of this tool by the professional will improve its effectiveness. Copyright © 2005 FEND. [source] Effect of fluorocitrate on cerebral oxidation of lactate and glucose in freely moving ratsJOURNAL OF NEUROCHEMISTRY, Issue 1 2007H. Ronald Zielke Abstract Glucose is the primary carbon source to enter the adult brain for catabolic and anabolic reactions. Some studies suggest that astrocytes may metabolize glucose to lactate; the latter serving as a preferential substrate for neurons, especially during neuronal activation. The current study utilizes the aconitase inhibitor fluorocitrate to differentially inhibit oxidative metabolism in glial cells in vivo. Oxidative metabolism of 14C-lactate and14C-glucose was monitored in vivo using microdialysis and quantitating 14CO2 in the microdialysis eluate following pulse labeling of the interstitial glucose or lactate pool. After establishing a baseline oxidation rate, fluorocitrate was added to the perfusate. Neither lactate nor glucose oxidation was affected by 5 ,mol/L fluorocitrate. However, 20 and 100 ,mol/L fluorocitrate reduced lactate oxidation by 55 ± 20% and 68 ± 12%, respectively (p < 0.05 for both). Twenty and 100 ,mol/L fluorocitrate reduced 14C-glucose oxidation by 50 ± 14% (p < 0.05) and 24 ± 19% (ns), respectively. Addition of non-radioactive lactate to 14C-glucose plus fluorocitrate decreased 14C-glucose oxidation by an additional 29% and 38%, respectively. These results indicate that astrocytes oxidize about 50% of the interstitial lactate and about 35% of the glucose. By subtraction, neurons metabolize a maximum of 50% of the interstitial lactate and 65% of the interstitial glucose. [source] Evaluation of a Novel Real-Time Continuous Glucose-Monitoring System for Use in CatsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010S. Moretti Background: The Guardian REAL-Time is a continuous glucose-monitoring system (CGMS) recently developed to provide instantaneous interstitial glucose concentrations; the system does not require a monitor being fixed to the animal. Hypothesis: The CGMS provides accurate and reproducible real-time readings of glucose concentration in cats. Animals: Thirty-two diabetic cats, 2 cats with suspected insulinoma, and 5 healthy cats. Methods: Prospective, observational study. CGMS accuracy was compared with a reference glucose meter at normal, high, and low blood glucose concentrations using error grid analysis. Reading variability of 2 simultaneously used CGMS was determined in diabetic cats by calculating correlation and percentage of concordance of paired data at different glycemic ranges. The time interval between increasing glycemia and a rise in interstitial fluid glucose measured by the CGMS was assessed in healthy cats receiving glucose IV; the time point of maximal increase in interstitial glucose concentrations was calculated. Results: The CGMS was 100, 96.1, and 91.0% accurate at normal, high, and low blood glucose concentrations. Measurements deviated from reference by ,12.7 ± 70.5 mg/dL at normal, ,12.1 ± 141.5 mg/dL at high, and ,1.9 ± 40.9 mg/dL at low glucose concentrations. Overall, paired CGMS readings correlated significantly (r= 0.95, P < .0001) and concordance was 95.7%. The median delay after IV administration of glucose to an increase in interstitial glucose was 11.4 minutes (range: 8.8,19.7 minutes). Conclusions and Clinical Importance: Although some readings substantially deviated from reference values, the CGMS yields reproducible results, is clinically accurate in cats with hyperglycemia and euglycemia, and is slightly less accurate if blood glucose concentrations are low. Rapidly increasing interstitial glucose after a glycemic rise suggests that the CGMS is suitable for real-time measurement under clinical conditions. [source] | |||||||||||||