Biomedical subjects
Publications and source records attributed to J Bergeler.
Blood glucose self-monitoring is essential to stabilize diabetes on a normoglycemic level. But often patients do not find the correct insulin adaptation. Therefore, we developed a computerized system which adapts insulin doses using a control matrix. During a first in-patient period we had a remarkable blood glucose normalization and stabilization.
We developed a program for a pocket computer (Sharp PC-1500) enabling conversion to and optimizing of meal-related insulin injection regimens. The dosage of regular insulin injected at meal times by a penshaped device (Novo Pen) was calculated in dependence of the carbohydrate content of the ingested meal, daytime, difference of actual and target blood glucose, 4 daily glucose levels of the last 2 or 4 days and physical activity. Long-acting insulin was proposed in dependence of morning blood levels of the preceding days. The response to elevated levels was additionally determined by night values. All quantifications were based on equivalent factors reflecting relations between insulin need and blood glucose changes and carbohydrate intake, respectively. This permits a so-called "quantified adaptation", where all these factors are individually defined and steadily actualized by the computer according to the data processed during adaptation. In a controlled cross-over study 12 type 1 diabetics were treated with conventional therapy (CT = 2-3 injections daily) and computer-assisted meal-related insulin therapy (CAMIT = 3-4 injections daily), each for a 6 weeks period. Although the number of meals was reduced from 6-7 to 3-5 and carbohydrate intake was allowed to vary from day to day, parameters of metabolic control were significantly improved by CAMIT compared to CT: mean blood glucose decreased from 9.10 +/- 2.96 to 6.22 +/- 0.65 mmol/l with CAMIT and only from 8.86 +/- 1.83 to 6.91 +/- 0.90 mmol/l with CT (p less than 0.05) and HbA1 from 10.2 +/- 1.5 to 8.6 +/- 0.8% with CAMIT and only from 9.8 +/- 1.3 to 9.1 +/- 1.0% with CT.(ABSTRACT TRUNCATED AT 250 WORDS)
Considerable interest has recently been focused on the computer as a new method to improve outpatient treatment of insulin dependent diabetics. Different ways of programming procedures have been proposed to simulate an experienced physician's capability to adjust insulin dosage in a mathematical form. We report here the results of a controlled study with a program for conventional insulin therapy in in- and outpatient treatment. Eleven inpatient type-I-diabetics could be well controlled after 8 days, and 6 outpatient treated type-I-diabetics improved all relevant metabolic parameters after 30 days compared to a control period of the same duration. So, computer assisted therapy promises to be a worthful aid in the treatment of diabetes.
Blood glucose self-monitoring is essential to stabilize diabetes on a normoglycemic level. However, patients often do not find the correct insulin adaptation. Therefore, we developed a computer system to adapt insulin doses using a control matrix. During a first inpatient and outpatient period, we attained a very satisfactory blood glucose normalization and stabilization. During the outpatient period the HbA1c values decreased. Stopping the program in some patients blood glucose levels and HbA1c values increased again.
A system is described for the high-accuracy measurement of the flow resistance of tracheostomy tubes without and with speaking valves during the phase of inspiration with regard to different conditions up to flows of 78 l/min. A microprocessor is employed for the acquisition of the signals and for the presentation of the results by means of a plotter. The results show that the flow resistance of tracheostomy tubes with two speaking valves of different construction in vertical position does not exceed the critical value of 5 mbar.s/l. Lateral tilting does not affect the flow resistance, whereas frontal tilting yields an increase in flow resistance.