RU2198586C2 - Method of determining blood glucose level - Google Patents

Abstract

FIELD: analytical methods in medicine. SUBSTANCE: systolic and diastolic arterial pressures are measured consecutively on right and left arms of hungry patient in the morning and correlation coefficient K is then found, the latter being ratio of the highest value of systolic arterial pressures measured on right and left arms to lowest value of diastolic arterial pressures measured on right and left arms, after which blood glucose level is calculated by formula P = 0,245•E^1,9·K (mmol/l) wherein E is constant equal to 2.71828 and K correlation coefficient. EFFECT: reduced examination time and enabled noninvasive examination procedure. 1 tbl, 3 ex

Description

 The invention relates to medicine, in particular to endocrinology, and can be used for preliminary diagnosis of type II diabetes mellitus during preventive examinations of the population.

 A known method for the diagnosis of diabetes, including determining the concentration of glucose in blood plasma using a biochemical analysis / 1 /.

 The disadvantages of the method include the need for blood sampling for analysis, which is a risk factor for infectious diseases, and significant costs for equipment and reagents for biochemical analysis.

 The purpose of the invention is to increase the safety of the diagnostic method and reduce the cost of its implementation.

 This goal is achieved by the fact that the examination is carried out in the morning, on an empty stomach, by measuring the parameters of systolic and diastolic blood pressure sequentially on the left and right hands of the patient, and as a criterion for determining the concentration of glucose in the blood, use the dimensionless correlation coefficient, which is the ratio of the largest of the measured values systolic blood pressure on the left and right hands to the lowest measured diastolic blood pressure on the left and right arms, wherein each value of the correlation coefficient corresponds to a unique index value in the blood glucose concentration is determined empirically.

 Improving the safety of the method is achieved by eliminating blood sampling for analysis, since the examination is carried out by measuring the parameters of blood pressure (BP) using a sphygmomanometer and a phonendoscope. Cost reductions are achieved due to the use of universal measuring equipment for diagnostics, which has a lower cost.

 Blood pressure parameters to the greatest extent characterize the systemic functional state of the body in normal and pathological conditions. In healthy people, normally, the levels of systolic and diastolic blood pressure on both hands are the same or slightly different, and their ratio according to WHO criteria is 1.5 ± 0.02. In the case of a disease, both the absolute indicators of blood pressure and their ratio on the left and right hands change.

 Impaired carbohydrate metabolism is the cause of a complex endocrine disease - diabetes. With relative insulin deficiency, type II diabetes mellitus develops (non-insulin-dependent diabetes mellitus). Since violations of carbohydrate metabolism lead in most cases to damage to the cardiovascular system, diabetes is considered a risk factor for the development of hypertension, coronary heart disease, myocardial infarction, and stroke. At the same time, diseases of the cardiovascular system, including arterial hypertension, are a risk factor for the development of diabetes mellitus, as they provoke a hereditary inferiority of beta cells of pancreatic islets, impaired insulin biosynthesis, reduce the sensitivity of tissues to insulin, and reduce glucose tolerance / 2 /. The interdependence of carbohydrate metabolism disorders and diseases of the cardiovascular system is considered obvious, since the body is a homeostatic, self-regulating system that adapts to the conditions of existence.

 Based on our experimental studies, we have established a correlation between blood glucose and blood pressure in patients with type II diabetes mellitus. It has been proven that blood pressure increases with increasing concentrations of glucose in the blood. At the same time, systolic blood pressure increases more than diastolic blood pressure, which leads to an increase in the difference in systolic and diastolic blood pressure, and, consequently, the ratio of these indicators as blood glucose concentration increases. The ratio of systolic blood pressure to diastolic blood pressure uniquely and qualitatively characterizes the level of glycemia, so we chose it to describe the relationship between the concentration of glucose in the blood and blood pressure. The empirical equations describing this interdependence are derived by the method of mathematical statistics.

The results of the examination of 90 patients with type II diabetes mellitus of 1-2 severity were subjected to statistical processing. When examining all patients in the morning, on an empty stomach, blood pressure was measured sequentially on the left and right hands, after which a biochemical blood test was immediately performed on the Eskan apparatus to determine the glucose content in blood plasma. The correlation coefficient "K" was calculated as the ratio of the highest systolic blood pressure to the lowest diastolic blood pressure from the measured values on the left and right hands. As a result of statistical data processing, a regression equation was obtained that gives good agreement with the experimental points - the adequacy is 96-98%
P = 0.245 • E ^{1.9 • K} ,
where P is the glucose content in the blood, mmol / l;
E is a constant, E≈2.71828;
K is the correlation coefficient.

 By calculating the correlation coefficient "K", you can determine the glucose content in the blood using the above formula. For convenience, this dependence is presented in the form of a table.

 The table shows the calculated values of the correlation coefficient and the calculated values of glucose in the blood. Intermediate values can be found by linear interpolation.

 Sequence of performance of receptions.

1. When examining a patient in the morning, on an empty stomach, measure the parameters of blood pressure, in mm Hg:
- the level of systolic blood pressure on the left hand - A ₁ ;
- the level of diastolic blood pressure on the left hand - And ₂ ;
- the level of systolic blood pressure on the right hand - A ₃ ;
- the level of diastolic blood pressure on the right hand - A ₄ .

2. Compare the indicators A ₁ and A ₃ , choose the highest - HELL _max . Compare indicators A ₂ and A ₄ , choose the smallest - HELL _min .

3. Calculate the correlation coefficient
K = HELL _max / HELL _min
4. Calculate the glucose level in the blood according to the formula
P = 0.245 • E ^{1.9 • K} mmol / L.
You can also use the table above.

 Examples of specific performance.

Example 1. When examining a patient measured blood pressure parameters
A ₁ = 100, A ₂ = 70, A ₃ = 110, A ₄ = 70 mmHg

2. Choose the highest value of systolic blood pressure
HELL _max = 110 mm Hg

Choose the lowest diastolic blood pressure
HELL _min = 70 mm Hg

 3. We calculate the correlation coefficient K = 110/70; K = 1.57.

4. Determine the glucose content in the blood according to the table
P = 4.84 mmol / L.

 This corresponds to the normal level of glycemia.

 Example 2

1. During the examination of the patient measured blood pressure
A ₁ = 150, A ₂ = 80, A ₃ = 152, A ₄ = 85 mmHg

2. Choose the highest value of systolic blood pressure
HELL _max = 152 mm Hg

Choose the lowest diastolic blood pressure
HELL _min = 80 mm Hg

3. We calculate the correlation coefficient
K = 158/80; K = 1.9.

4. We determine the glucose content in the blood according to the formula
P = 0.245 • E ^{1.9 • 1.9} ; P = 9.06 mmol / L
This corresponds to an increased level of glycemia.

 Example 3

1. During patient examinations, blood pressure parameters were measured
A ₁ = 164, A ₂ = 80, A ₃ = 160, A ₄ = 78 mmHg

2. Choose the highest value of systolic blood pressure
HELL _max = 164 mm Hg

Choose the lowest diastolic blood pressure
HELL _min = 78 mm Hg

3. We calculate the correlation coefficient
K = 164/78; K = 2.10
4. Determine the glucose content in the blood according to the table
P = 13.24 mmol / L
This corresponds to a high level of glycemia.

 The advantages of the proposed diagnostic method compared to the prototype method include reducing the examination time, the ability to quickly process the results on a computer and making a diagnosis, identifying hidden forms of diabetes.

 The proposed method for the diagnosis of diabetes can be used as an express method for conducting mass preventive examinations of the population.

Sources of information
1. Kamysheva E.M., Pokalev G.M. Diabetes mellitus: current presentation, clinical symptoms, syndromes, medical practice. - N. Novgorod: Publishing House of the Nizhny Novgorod State. honey. Acad., 1999, p. 71-73.

 2. Dedov I.I., Suntsov Yu.I., Kudryakova S.V., Ryzhkova S.G. Epidemiology of non-insulin-dependent diabetes mellitus.// Probl. endocrinol. - 1998, - 3, p. 45-47.3

Claims (1)

A method for determining blood glucose concentration, characterized in that in the morning, on an empty stomach, systolic and diastolic blood pressure are measured sequentially on the patient's left and right hands, a correlation coefficient K is determined, which is the ratio of the largest of the measured systolic blood pressure on the left and right hands to the smallest of the measured values of diastolic blood pressure on the left and right hands, and the blood glucose R is calculated by the formula, mmol / l:
P = 0.245 • E ^{1.9 • k} ,
where E is a constant, E≈2.71828;
K is the correlation coefficient.

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