1,721,242 research outputs found
Mini-doses of glucagon to prevent hypoglycemia in children with type 1 diabetes refusing food: a case series
Aims: Hypoglycemia in small children with type 1 diabetes is difficult to manage if nausea, vomit or food refusal occurs. If oral carbohydrate cannot be used, there is a hypothetical risk of severe hypoglycemia. The present article describes the effect on glucose of small doses of subcutaneous glucagon to revert hypoglycemia and prevent severe events in small children with type 1 diabetes using a continuous glucose monitoring. Methods: We analyzed 4 episodes of impending or mild hypoglycemia in 3 children with type 1 diabetes who refused to eat carbohydrates. Using a standard U-100 insulin syringe, children received one “unit” (10 μg) of glucagon subcutaneously for every year of age up to 15 units (150 μg). If the blood glucose did not increase within 30 min, the initial dosage was repeated at that time. Instructions were given by phone from the physician. At the following visit data from continuous glucose monitoring devices, insulin pump and glucometer were downloaded and reviewed retrospectively from the physician. Results: Blood glucose from continuous glucose monitoring after one and 2 h was 127 ± 80 mg/dl and 165 ± 78 mg/dl, respectively. After a glucagon injection, there was a single recurrence of hypoglycemia, requiring another shot. The glucagon was well tolerated, except for nausea, present before the injection. None of the children were taken to our hospital because of concerns for hypoglycemia. Conclusion: Mini-doses of glucagon given subcutaneously were effective and safe in preventing frank or impending hypoglycemia in type 1 diabetes children refusing food
The best is the enemy of the good: Time for a biopsy-sparing approach for Helicobacter pylori diagnosis and treatment in children in the COVID-19 era?
Data-Driven Disturbance Estimation and Control with Application to Blood Glucose Regulation
A data-driven control approach for nonlinear systems is proposed, called data-driven estimation and control (D2EC), which combines a disturbance estimator and a nonlinear control algorithm. The estimator provides a signal representing the unknown disturbances affecting the plant to control. This signal is used by the control algorithm to improve its performance. A real-data study is presented, concerned with the regulation of blood glucose concentration in type 1 diabetic patients. Preliminary tests of the D2EC approach are also carried out using a diabetic patient simulator, obtained from a revised version of the well-known University of Virginia/Padova model. Both the real-data and the simulator-based studies indicate that the proposed approach has the potential to become an effective tool in the context of diabetes treatment and, more in general, in the biomedical field, where accurate first-principle models can seldom be found and relevant disturbances are present
Diabetes ketoacidosis management in children and adolescents. ISPAD vs ISPED: similarities and differences
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