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T Strack

Publications and source records attributed to T Strack.

10 recordsLinked to original sources
PubMed1990

[Computer-assisted diabetes therapy--a challenge for modern medicine].

By the use of computers in the therapy of diabetes new diagnostic and therapeutic possibilities are brought about. The computers open the possibility for a comprehensive data seizing, evaluation of the stored material and possibilities of various abilities for demonstration. Moreover, it becomes possible to regulate the therapy more subtly with the help of self-adapting programs and in its consequence to render it more effective than the own management of therapy is able to do it. This manifests itself significantly in badly or only moderately stabilised diabetics. In very well educated and trained diabetics even the superiority of the management of the computer becomes visible. Here this can no more be shown in the improvement of the stabilisation of diabetes which can no more be improved without risks for the patient. In these patients it is the reduction of the frequency of hyperglycaemia, by means of which can be shown that the stabilisation of diabetes in diabetics who were well stabilised already before can still be improved by the computer therapy. In addition to this the computer seems to cause further positive effects on the learning behaviour of the diabetics.

Blood Glucose↗
PubMed1989

[Osteoporosis: a case report].

A 56-year-old female patient was admitted to our hospital because she was suffering from severe osteoporosis. The patient had experienced repeated spontaneous fractures for 1.5 years such as serial rib fractures, fractures of the sternum and most recently fracture of the neck of the femur after a minimal trauma. Histology revealed a low-turnover-osteoporosis. Subsequent radiologic examination showed extreme osteoporosis of the skeleton with numerous compression fractures of the vertebral bodies as the most outstanding finding. The bone histology and the relatively short history of spontaneous fractures led us to investigate endogenous hypercortisolism as a possible cause although clinical signs were absent. An attenuated diurnal variation of cortisol levels and lack of suppressibility of cortisol was found. Furthermore, magnetic resonance tomography showed a microadenoma of the pituitary gland. Computerized tomography of the adrenals was normal. Transsphenoidal surgery confirmed the tentative diagnosis and histological examination revealed a bilateral adenoma of the pituitary gland.

Adenoma↗
PubMed1988

Compliance in microcomputer-assisted conventional insulin therapy: computer simulation study results.

Compliance in diabetes self-management is a complex issue. It involves the interdependent daily actions of self-measurement of blood glucose and adherence to a prescribed schedule of daily activities. This impacts strongly on lifestyle because it necessitates precise meal timing as well as control of size and carbohydrate content. We sought to identify how strongly relaxing the lifestyle constraints per se would impact the ability to achieve improved metabolic control. To isolate these effects from those that result from poor measurement compliance, we used a computer simulator called OMNI et al. Furthermore, to standardize the "clinical" therapy, a second microprocessor device called an "Insulin Dosage Computer" was used to adjust insulin doses based on the usual clinical practice of four times a day precibal blood glucose measurements. Ten type 1 diabetic patients were stimulated and each followed for 120 simulated days. In each such subject, the simulation was repeated three times to include three different levels of lifestyle compliance ranging from excellent to poor. In all three protocols, starting from a level of poor control of diabetes, mean blood glucose values were significantly improved without significant differences after 120 days of computer-simulated treatment. Only the standard deviations, expressing the fluctuations of blood glucose and hence its stability, increased with decreasing lifestyle compliance. This computer simulation predicts that consistent self-monitoring of four blood glucose values per day is the cornerstone of diabetic self-control and that the use of these data according to a standardized therapeutic algorithm for insulin adjustment may successfully stabilize even patients with poor lifestyle compliance. Clinical studies must follow.

Blood Glucose↗
PubMed1987

Selective in situ pancreatic perfusion via chronic in vivo celiac artery catheterization.

A new technique to catheterize the celiac artery has been developed. This has opened the possibility for direct in vivo, in situ study of pancreatic endocrine cell function in a conscious experimental animal. The catheter is small, soft and placed without arterial ligation so that celiac artery, hepatic, splenic, and pancreatic blood flows were essentially not compromised. Arterial vessel integrity, absence of inflammation, and thrombosis as well as catheter patency were achieved for periods exceeding eight months. Metabolically and hormonally, the presence of the catheter had no effect on the fasting status. However, we found somewhat lower glucose levels and higher insulin levels in the response to oral glucose challenges after catheterization, but these differences were statistically not significant. Glucose loads of 50 mg/kg (0.75 g) administered directly to the pancreas via the celiac artery produced peak insulin levels similar to peripheral glucose loads some tenfold larger. We suggest that this technique may be useful to selectively study the first-pass pancreatic response to a variety of hormones, drugs or metabolic substrates.

Administration, Oral↗
PubMed1986

[Selective blood sampling from the inferior petrosal sinus using digital subtraction angiography].

Simultaneous bilateral venous sampling of blood from the inferior petrosal sinuses helps in the differentiation between peripheral and central ACTH hypersecretion. One can also locate the site of a hormonally active hypophyseal micro-adenoma that cannot be demonstrated by other methods. The authors have experience with fifteen patients and discuss the indications, technique and problems as well as the advantages of using digital subtraction angiography.

Adenoma↗
PubMed1985

Computer assisted conventional insulin therapy.

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↗
PubMedDate not supplied

The influence of different generations of computer algorithms on diabetes control.

With all control schedules, the management of diabetes is possible using Skyler's algorithm. In general, those control algorithms which do not allow the individual adaptation to changing conditions lead to overinsulinisation. So-called meal-related algorithms do usually minimise the fluctuations in blood sugar. The introduction of self-adapting algorithms, detecting peripheral insulin resistance, may further improve metabolic diabetes control.

Algorithms↗
PubMedDate not supplied

Developmental and application of insulin infusion profiles for therapy of type-I diabetics with portable insulin infusion systems.

We studied the insulin requirements of seven insulin-dependent diabetics applying a glucose controlled insulin infusion system. The data were transformed into individually programmed and rectangular profiles. The MAGE, a measure of blood sugar fluctuations, was significantly lower when individually programmed step profiles were used (P less than 0.005) than it was when rectangular profiles were applied: 57.7 +/- 24.8 mg/dl vs 89.0 +/- 42.9 mg/dl. The average of measured blood glucose levels was significantly lower in individually programmed infusion profiles (P less than 0.025). The combination of individually programmed profiles and preprandial insulin bolus significantly reduced the postprandial blood glucose level and increase (P less than 0.001). Our investigations suggest that individually programmed insulin infusion profiles are able to smooth blood glucose fluctuations. When combined with an initial insulin bolus they may lead to a reduced insulin consumption after meals.

Adult↗