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Plasma Insulin Levels and Hypoglycemia Affect Subcutaneous Interstitial Glucose Concentration

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Plasma Insulin Levels and Hypoglycemia Affect Subcutaneous Interstitial Glucose Concentration

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dc.contributor.author Moscardo-Garcia, Vanessa es_ES
dc.contributor.author Bondía Company, Jorge es_ES
dc.contributor.author Ampudia-Blasco, Francisco Javier es_ES
dc.contributor.author Fanelli, Carmine G es_ES
dc.contributor.author Lucidi, Paola es_ES
dc.contributor.author Rossetti, Paolo es_ES
dc.date.accessioned 2020-03-16T14:46:57Z
dc.date.available 2020-03-16T14:46:57Z
dc.date.issued 2018-03 es_ES
dc.identifier.issn 1520-9156 es_ES
dc.identifier.uri http://hdl.handle.net/10251/138967
dc.description.abstract [EN] Background: Continuous glucose monitoring (CGM) accuracy during hypoglycemia is suboptimal. This might be partly explained by insulin or hypoglycemia-induced changes in the plasma interstitial subcutaneous (SC) fluid glucose gradient. The aim of the present study was to assess the role of plasma insulin (PI) and hypoglycemia itself in the plasma and interstitial SC fluid glucose concentration in patients with type 1 diabetes mellitus. Methods: Eleven subjects with type 1 diabetes (age 36.59.1 years, HbA(1c) 7.90.4% [62.8 +/- 2.02mmol/mol]; mean +/- standard deviation) were evaluated under hyperinsulinemic euglycemia and hypoglycemia. Each subject underwent two randomized crossover clamps with either a primed 0.3 (low insulin) or 1mU/(kgmin) (high insulin) insulin infusion. The raw CGM signal was normalized with median preclamp values to obtain a standardized measure of the interstitial glucose (IG) concentration before statistical analysis. Results: The mean PI concentration was greater in high insulin studies (HISs) versus low insulin studies (LISs) (412.89 +/- 13.63 vs. 177.22 +/- 10.05pmol/L). During hypoglycemia, glucagon, adrenaline, free fatty acids, glycerol, and beta-OH-butyrate were higher in the LIS (P<0.0001). Likewise, the IG concentration was significantly different (P<0.0001). This was due to lower IG concentration than plasma glucose (PG) concentration during the euglycemic hyperinsulinemic phases in the HIS. In contrast, no difference was observed during hypoglycemia. This was the result of an unchanged PG/IG gradient during the entire LIS, while in the HIS, this gradient increased during the hyperinsulinemic euglycemia phase. Conclusion: Both PI levels and hypoglycemia affect the relationship between IG and PG concentration. ClinicalTrials.gov Identifier: NCT01714895. es_ES
dc.description.sponsorship The research leading to these results received funding from the European Union Seventh Framework Programme (FP7/2007/2013) under the grant agreement 252085 and FEDER funds, as well as the Spanish Ministry of Economy and Competitiveness (MINECO) under the grants DPI2013-46982-C2-1-R and DPI2016-78831-C2-1-R.V.M. is recipient of an FPU grant ref FPU13/04253. We are grateful to Mrs. Sara Correa, Fundacion INCLIVA-Hospital Clinico Universitario de Valencia, and Mrs. Geles Viguer, Hospital Clinico Universitario de Valencia, for their invaluable help in conducting the study. es_ES
dc.language Inglés es_ES
dc.publisher Mary Ann Liebert es_ES
dc.relation.ispartof Diabetes Technology & Therapeutics es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject Interstitial glucose es_ES
dc.subject Hypoglycemia es_ES
dc.subject Subcutaneous glucose sensing es_ES
dc.subject.classification INGENIERIA DE SISTEMAS Y AUTOMATICA es_ES
dc.title Plasma Insulin Levels and Hypoglycemia Affect Subcutaneous Interstitial Glucose Concentration es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1089/dia.2017.0219 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/252085/EU/Seeking solutions for the artificial pancreas: new methods for improving continuous glucose monitoring and closed-loop postprandial glycaemic control./
dc.relation.projectID info:eu-repo/grantAgreement/MECD//FPU13%2F04253/ES/FPU13%2F04253/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//DPI2013-46982-C2-1-R/ES/NUEVOS METODOS PARA LA EFICIENCIA Y SEGURIDAD DEL PANCREAS ARTIFICIAL DOMICILIARIO EN DIABETES TIPO 1/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//DPI2016-78831-C2-1-R/ES/SOLUCIONES PARA LA MEJORA DE LA EFICIENCIA Y SEGURIDAD DEL PANCREAS ARTIFICIAL MEDIANTE ARQUITECTURAS DE CONTROL MULTIVARIABLE TOLERANTES A FALLOS/ es_ES
dc.rights.accessRights Cerrado es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería de Sistemas y Automática - Departament d'Enginyeria de Sistemes i Automàtica es_ES
dc.description.bibliographicCitation Moscardo-Garcia, V.; Bondía Company, J.; Ampudia-Blasco, FJ.; Fanelli, CG.; Lucidi, P.; Rossetti, P. (2018). Plasma Insulin Levels and Hypoglycemia Affect Subcutaneous Interstitial Glucose Concentration. Diabetes Technology & Therapeutics. 20(4):263-273. https://doi.org/10.1089/dia.2017.0219 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1089/dia.2017.0219 es_ES
dc.description.upvformatpinicio 263 es_ES
dc.description.upvformatpfin 273 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 20 es_ES
dc.description.issue 4 es_ES
dc.relation.pasarela S\361786 es_ES
dc.contributor.funder European Commission es_ES
dc.contributor.funder Ministerio de Economía y Competitividad es_ES
dc.contributor.funder Ministerio de Educación, Cultura y Deporte es_ES


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