Summary
The insulin treatment of 8 insulin-dependend diabetics was controlled with a microprocessor (Better Control Medical Computer, BCMC, Inc., Toronto, Canada) with information derived from blood or first voided urine glucose concentrations assessed by reagent strips four times a day, before the three main meals and bedtime snack. The microprocessor recommends modification of the insulin doses so as to reach a pre-prandial blood glucose value of 110 mg/dl or a urine glucose concentration of 0.1 g/dl. During the first two weeks self-management was uniformly applied by the patients, based on their blood glucose concentration. Subsequently, it was continued by the patients who were divided into two groups, one using the blood, the other the urine glucose concentrations, each for three weeks, alternately. During microprocessor treatment the patients’ mean blood glucose profiles decreased from 152±37 mg/dl to 126±28 mg/dl. No difference was found between treatments based on blood or urine glucose concentrations concerning either the mean blood glucose profiles or the number of hypoglycemic episodes in the presence of an average glucose threshold and good renal function. The first voided urine glucose concentration and mean and maximal blood glucose values obtained at the time of urine filtration were closely correlated (r=0.82 and 0.86, p<0.001).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Diabetes Association: Self-monitoring of blood glucose — Diabetes Care8, 515, 1985.
Banaugh D., Koller P. U., Bablok W.: Evaluation of Diabur-Test 5000: a cooperative study carried out by 12 diabetes centres — Diabetes Care6, 213, 1983.
Griffin N. K., Smith M. A., Jenkins P. A., Werthner C., Baum J. D.: Relationship between urinary and blood glucose in diabetic children — Arch. Dis. Childh.54, 371, 1974.
Hayford J. T., Weydert J. A., Thompson R. G.: Validity of urine glucose measurements for estimating plasma glucose concentration — Diabetes Care6, 40, 1983.
Hermáñyi I., Tamás Gy. Jr., Kerényi Zs., Gerő L.: Use of microprocessor at the first insulinisation of diabetic patients — Magyar Belorv. Arch.39, 315, 1986.
Irsigler K., Bali-Taubald C.: Self-monitored blood glucose. The essential biofeedback signal in the diabetic patient’s effort to achieve normoglycemia — Diabetes Care3, 163, 1980.
Johansen K., Svendsen P. Aa., Lørup B.: Variations in renal threshold for glucose in type I (insulin-dependent) diabetes mellitus — Diabetologia26, 180, 1984.
Kattermann R., Frey H. O., Ballies U., Kutter D., von Oudheusden A. P., von Buul T., Klein H. J., Forster E., Banauch D., Koller P. U.: Daibur-Test ®5000-ein neuer Teststreifen zur Harnzuckerkontrolle des Diabetikers — Dtsch. med. Wschr.107, 97, 1982.
Knowles H. C. Jr.: Magnitude of renal failures problem in diabetic patients — Kidney int.4, 52, 1974.
Lawrence R. D.: Renal threshold for glucose: normal and in diabetics — Brit. med. J.i, 766, 1940.
Legg E. F., Sammons H. G.: Performance of blood glucose analysers — Lanceti, 1194, 1979.
Magyar I., Petrányi Gy.: Outlines of medicine. Medicina, Budapest, 1986; p. 1727.
Malone J. I., Rosenbloom A. L., Gric A., Weber F. T.: The role of urine sugar in diabetic management — Amer. J. Dis. Child.130, 1324, 1976.
Miller P. F. W., Stratton C., Tripp J. H.: Blood testing compared with urine testing in the long term control of diabetes — Arch. Dis. Child.58, 294, 1983.
Morris L. R., McGee J. A., Kitabchi A. E.: Correlation between plasma and urine glucose in diabetes — Ann. intern. Med.94, 469, 1981.
Pohl S. L., Cox D. J., Evans W. S.: Self measurement of blood glucose concentration: clinical significance of patient-generated measurements — Diabetes Care8, 617, 1985.
Reeves M. L., Forhan S. E., Skyler J. S., Peterson C. M.: Comparison of methods for blood glucose monitoring — Diabetes Care4, 404, 1981.
Schiffrin A., Mihic M., Leibel B. S., Albisser A. M.: Computer-assisted insulin dosage adjustment — Diabetes Care8, 545, 1985.
Service F. J., Molnar G. D., Taylor W. E.: Urine glucose analysis during continuous blood glucose monitoring — J. Amer. med. Ass.222, 294, 1972.
Skyler J. S., Skyler D. L., Seigler D. E., O’Sullivan M. J.: Algorithms for adjustment of insulin dosage by patients who monitor blood glucose — Diabetes Care4, 311, 1981.
Sönksen P. H., Judd S. L., Lowy C.: Home monitoring blood glucose: new approach to management of insulin dependent diabetic patients in Great Britain — Diabetes Care3, 100, 1980.
Stubbs S. M., Pzhe D. A., Brudenell J. M., Watkins P. J.: Management of the pregnant diabetic: home or hospital, with or without glucose meters? — Lanceti, 1122, 1980.
Tattersall R., Gale E.: Patient self-monitoring of blood glucose and refinements of conventional insulin treatment — Amer. J. Med.70, 177, 1981.
Tattersall R., Walford S., Peacock J., Gale E., Allison S.: A critical evaluation of method of monitoring diabetic control — Diabetes Care3, 150, 1980.
Walford S., Page M.McB., Allison S. P.: The influence of renal threshold in the interpretation of urine tests for glucose in diabetic patients — Diabetes Care3, 672, 1980.
Williams J. R., Alling K.: A program for normal glycemic control of insulin-dependent diabetes — Diabetes Care3, 672, 1980.
Wing R. R., Epstein L. H., Nowalk M. P., Scott N., Koeske R.: Compliance to self-monitoring of blood glucose: a marked-item technique compared with self-report — Diabetes Care8, 456, 1985.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hermányi, I., Tamás, G. Management of diabetics with the use of a microprocessor: Comparison of insulin treatments based on blood and urine glucose levels. Acta diabet. lat 25, 33–40 (1988). https://doi.org/10.1007/BF02581243
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02581243