Monitoring set-up for selection of parameters for detection of hypoglycaemia in diabetic patients

Abstract

Recurrent severe hypoglycaemia is often an unsolved problem in diabetic patients under intensified insulin treatment. As no reliable long-term stable blood glucose sensor has yet been developed, registration of other body function changes could help to detect severe hypoglycaemia. A measuring system is described, capable on the one hand of recording EEG, heart rate, peripheral pulse, skin temperature, respiratory movements, skin impedance and arterial blood pressure, and capable of registering plasma glucose, counter-regulatory hormones, symptoms and cognitive performance under experimental conditions during hypoglycaemia, on the other. In a clinical study involving both insulin-induced hypoglycaemia in healthy subjects and insulin-dependent diabetic patients, the practical value and the character of changes of the recorded parameters are investigated. Currently insensitivity to hypoglycaemia, impracticability, complexity or susceptibility to artefacts make use of most parameters unsuitable for hypoglycaemia prevention. It is believed, however, that future efforts could result in indirect registration of hypoglycaemia, including a qualified combination of different parameters, individual adaptation in accordance with particular responses of individual patients, together with new measuring and sensor techniques.

Electrocardiographic Signals and Swarm-Based Support Vector Machine for Hypoglycemia Detection

“…The higher QTc in hypoglycemia was confirmed in a previous study, 25 and the higher heart rate in hypoglycemia was also previously confirmed. 18 The higher values of the other ECG parameters, RTp c , QTp c , TpTe c , QTe c , and ToTe c in hypoglycemia, might be considered as these parameters are part of repolarization, in which repolarization prolongs in hypoglycemia. 39 …”

Deep learning framework for detection of hypoglycemic episodes in children with type 1 diabetes

“…For patients with Type1 and Type2 diabetes, the possibility of hypoglycemia is mainly effected by prolongation of QT intervals (starting from the point of Q wave to at the end of T wave) and its correlation to heart rate carried out by Bazett's formula QT c = QT RR [14]. Not only does QT c interval prolongation have a significant impact on hypoglycemia, but an increase in heart rate (HR) may also influence the status of hypoglycemia [15]. Studies on the natural occurrence of hypoglycemia with an increase in heart rate, (1.033±0.242 vs. 1.082±0.298, P < 0.06) and corrected QT intervals, (1.031 ± 0.086 vs. 1.060 ± 0.084, P < 0.01) have been successfully carried out in [16].…”

Hypo- and Hyperglycemic Alarms

“…15 Heger et al studied a myriad of signals on 7 patients and reported that the Sleep Sentry either failed to sound or sounded too late to be of use to the patient in 3 cases. 16 Studies by Johansen et al on the use of the Teledyne Sleep Sentry for detection of nocturnal hypoglycemia in 22 patients for a total of 63 nights resulted in 22 alarm sounds with 6 instances of hypoglycemia. 17 Thus, this study concluded with the similar 3:1 ratio of false alarms to true alarms as found by Clarke et al…”

“…[25][26][27] In 1996, Heger et al made numerous measurements on 7 healthy and 18 insulin-dependent diabetic subjects and concluded that changes in EEG frequencies were the earliest and most significant; however, this group also noted that problems with power consumption, miniaturization, and sensor numbers limited this technology for everyday use. 16 Unlike simple thresholds commonly used in skin conductance and skin temperature alarms, scientists have recently begun exploring more sophisticated analysis of EEG time series. Laione et al tested an experimental alarm system based on spectral analysis and artificial neural networks (ANNs) on 8 patients, reporting an average sensitivity and specificity of 71.1% and 71.5%, respectively, when subjects remained immobilized with their eyes shut during measurements.…”

“…16 Beginning in the mid-1990s, scientists have found correlations between a lengthened QT interval and hypoglycemia.…”