RU2368303C2 - Method of non-invasive determination of glucose concentration in blood - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to endocrinology. Systolic and diastolic arterial pressure is measured on an empty stomach and after food intake. Content of glucose in blood is calculated in mmole/l on an empty stomach (P) and after food intake (P1) by formulas: P=0.37*E^1.65*^C, where E is constant, E=2.71828, P1=0.65*E^1.5*^C1, where E is constant, E=2.71828, C and C1 are coefficients of correlation, which are determines as ratio of average arithmetic value of systolic arterial pressure to average arithmetic value of diastolic arterial pressure, measured on both patient's arms on an empty stomach (C) and after food intake (C1). Carbohydrates exchange disorder is determined by data of comparison of obtained indices P and P1 with criteria of sugar diabetes compensation.

EFFECT: extending arsenal of means of non-invasive determination of glucose concentration in blood.

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Description

The invention relates to medicine, in particular to endocrinology, and can be used in clinics and departments of medical institutions for monitoring blood glucose levels in the diagnosis of carbohydrate metabolism disorders.

A known method for determining the concentration of glucose in the blood according to patent RU 2198586 C2, 02.20.2003, including measuring in the morning, on an empty stomach, systolic and diastolic blood pressure sequentially on the left and right hands of the patient, determining the correlation coefficient K, which is the ratio of the largest of the measured values of systolic arterial 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 calculation of blood glucose P on oschak without blood sampling, according to the formula, mmol / L: P = 0.245 * e ^{1,9 * K,} wherein

K is the correlation coefficient; E is a constant, E = 2.71828.

The disadvantages of the method include the impossibility of a non-invasive determination of blood glucose after eating, which reduces the accuracy of diagnosing disorders of carbohydrate metabolism, since the level of glucose in the blood after eating is an indicator of post-nutritional glycemia and serves as a criterion for the degree of compensation of diabetes along with fasting glycemia (Dreval A. B. Treatment of uncomplicated non-insulin-dependent diabetes mellitus. // Problems of Endocrinology, 1995. - No. 4. - P.28).

The claimed invention solves the problem of increasing the accuracy of non-invasive determination of the concentration of glucose in the blood in the diagnosis of disorders of carbohydrate metabolism.

The method includes measuring in the morning, on an empty stomach, systolic and diastolic blood pressure sequentially on the left and right hands of the patient, determining the correlation coefficient K and calculating blood glucose using the empirical regression formula.

The essence of the invention lies in the fact that the calculation of fasting blood glucose R is carried out according to the formula, mmol / l: P = 0.37 * E ^{1.65 * K} , where E is a constant, E = 2.71828, K is the correlation coefficient on an empty stomach, and the fasting correlation coefficient K is defined as the ratio of the arithmetic mean value of systolic blood pressure to the arithmetic mean value of diastolic blood pressure, measured on both hands of the patient on an empty stomach; then, systolic and diastolic blood pressure are measured sequentially on the left and right hands of the patient immediately after eating, the correlation coefficient K1 is calculated as the ratio of the arithmetic mean of systolic blood pressure to the arithmetic mean of diastolic blood pressure measured on both hands of the patient after eating, and the glucose content in the blood immediately after a meal P1 is calculated by the formula, mmol / l: P1 = 0.65 * e ^{1,5 * K1,} where E - DC constant prices, E = 2.71828, K1 - correlation coefficient postprandial.

The technical result of the invention is to increase the accuracy of determining the concentration of glucose in the blood, which is achieved due to the fact that the proposed regression formula for calculating the concentration of glucose in the blood on an empty stomach and after eating, which reflect with a high degree of accuracy the correlation between the level of blood glucose and fluctuations in arterial parameters pressure.

The results of the examination of 90 patients with type 2 diabetes mellitus of moderate severity and 50 patients with arterial hypertension of 1-2 degrees at the age of 20 to 75 years with a disease duration of 2 to 8 years were subjected to statistical processing.

When examining all patients, the systolic and diastolic blood pressure (BP) values were measured sequentially on the left and right hands: in the morning, on an empty stomach, from 8 to 9 hours and after breakfast from 10 to 11 hours. Accuracy of blood pressure measurement ± 2 mm Hg Immediately after measuring blood pressure, a blood was drawn for biochemical enzymatic analysis, which was performed with an accuracy of ± 0.05 mmol / L. The fasting correlation coefficients (K) and after meals (K1) were calculated:

K = GARDEN / DBPc .; K1 = SAD1cp. / DAD1sr. In these equations:

CADL = 0.5 (CADL + CADR); DADav. = 0.5 (DADL + DADR);

CAD1 avg. = 0.5 (CAD ₁ L + CAD ₁ R); DBP1 avg. = 0.5 (DBP ₁ L + DBP ₁ R);

SADL, SADR, DADL, DADR - indicators of systolic blood pressure and diastolic blood pressure on the left and right hands of the patient, respectively, measured on an empty stomach, mmHg;

GARDEN ₁ L, GARDEN ₁ R, DBP ₁ L, DBP ₁ R - indicators of systolic blood pressure and diastolic blood pressure on the left and right hands of the patient, respectively, measured after eating, mm Hg

The parameters of the patient examination were processed using a computer program, as a result of which the exponential regression equations for calculating blood glucose were obtained, mmol / l:

- during measurements on an empty stomach: P = 0.37 * E ^{1.65 * K} ;

- when measured after eating: P1 = 0.65 * E ^{1.5 * K1} ,

where K is the fasting correlation coefficient; K1 - correlation coefficient after eating; E is a constant, E = 2.71828.

The range of measurement of fasting and postprandial blood glucose according to the above regression equations is from 2 to 20 mmol / L, the adequacy of coincidence with the baseline data is within 98-99%.

The results of calculating the level of glucose in the blood according to the given regression formulas are presented below in table form. Intermediate values can be found by linear interpolation.

№№ Fasting measurement Post-Meal Measurement Correlation coefficient, K Glucose content, mmol / l The degree of compensation for diabetes Correlation coefficient, K1 Glucose content, mmol / l The degree of compensation for diabetes one 1,2 2.68 Low level 1,2 3.93 Low level 2 1.25 2.91 1.25 4.24 3 1.3 3.16 1.3 4,57 four 1.35 3.43 1.35 4.92 Good compensation 5 1.4 3.73 Good compensation 1.4 5.31 6 1.45 4.05 1.45 5.72 7 1,5 4.40 1,5 6.17 8 1.55 4.77 1.55 6.65 9 1,6 5.18 1,6 7.17 10 1.65 5.63 1.65 7.72 eleven 1.7 6.12 1.7 8.32 12 1.75 6.64 1.75 8.97 Acceptable Compensation 13 1.8 7.21 Acceptable Compensation 1.8 9.67 fourteen 1.85 7.83 1.85 10.43 fifteen 1.9 8.51 Poor compensation 1.9 11.24 Poor compensation 16 1.95 9.24 1.95 12.11 17 2 10.03 2 13.06 eighteen 2.05 10.89 2.05 14.07 19 2.1 11.83 2.1 15.17 twenty 2.15 12.85 2.15 16.35 21 2.2 13.95 2.2 17.62

Sequence of performance of receptions

1. When examining a patient in the morning, on an empty stomach, measure the parameters of blood pressure, mm Hg:

- systolic blood pressure (A1) and diastolic blood pressure (A2) on the left hand;

- systolic blood pressure (A3) and diastolic blood pressure (A4) on the right hand.

2. Calculate the arithmetic mean values on an empty stomach, mmHg:

- systolic blood pressure: CAD = 0.5 (A1 + A3);

- diastolic blood pressure: DADavr. = 0.5 (A2 + A4);

3. Calculate the correlation coefficient on an empty stomach:

K = SADSr. / DADsr.

4. Calculate the fasting blood glucose by the formula:

P = 0.37 * E ^{1.65 * K} , mmol / L. You can also use the table below.

5. Measure the parameters of blood pressure immediately after eating, mmHg:

- systolic blood pressure (A5) and diastolic blood pressure (A6) on the left hand;

- systolic blood pressure (A7) and diastolic blood pressure (A8) on the right hand.

6. Calculate the arithmetic mean values of blood pressure parameters after eating, mmHg:

- systolic blood pressure: CAD1 avg. = 0.5 (A5 + A7);

- diastolic blood pressure: DAD1avr. = 0.5 (A6 + A8).

7. Calculate the correlation coefficient after eating:

K1 = CAD1sr. / DBP1sr.

8. Calculate the glucose content in the blood after eating according to the formula: P1 = 0.65 * E ^{1.5 * K1} , mmol / L. You can also use the table below.

To characterize the level of glycemia and diagnose disorders of carbohydrate metabolism, the obtained indicators of fasting glucose R and glucose after eating P1 are compared with criteria for diabetes compensation (Dreval A.V. Treatment of uncomplicated non-insulin-dependent diabetes mellitus. // Problems of Endocrinology, 1995. - No. 4. - P.28).

Case Studies

Example 1

1. During the examination of the patient measured fasting blood pressure, mm Hg:

A1 = 120; A2 = 80; A3 = 118; A4 = 74.

2. We calculate the arithmetic mean values, mm Hg:

SADav. = 119; DBP Avg. = 77.

3. We calculate the correlation coefficient on an empty stomach: K = 119/77 = 1.55.

4. Determine the fasting blood glucose by the formula:

P = 0.37 * E ^{1.65 * K} or according to the table: P = 4.77 mmol / L.

5. We measure the parameters of blood pressure after eating, mm Hg:

A5 = 126; A6 = 80; A7 = 130; A8 = 80.

6. We calculate the arithmetic mean values, mm Hg:

SAD1avr. = 128; DBP1 avg. = 80.

7. We calculate the correlation coefficient after eating:

K1 = 128/80 = 1.6.

8. Determine the glucose level in the blood after a meal by the formula:

P1 = 0.65 * E ^{1.5 * K1} or according to the table: P = 7.17 mmol / L.

Fasting blood glucose (P = 4.77 mmol / L) and postprandial glucose (P1 = 7.17 mmol / L) correspond to a good degree of compensation for carbohydrate metabolism disorders, so further studies may not be carried out.

Example 2

1. During the examination of the patient measured fasting blood pressure, mm Hg:

A1 = 138; A2 = 76; A3 = 132; A4 = 74.

2. We calculate the arithmetic mean values, mm Hg:

SADav. = 135; DBP Avg. = 75.

3. We calculate the correlation coefficient on an empty stomach: K = 135/75 = 1.8.

4. Determine the fasting blood glucose by the formula:

P = 0.37 * E ^{1.65 * K} or according to the table: P = 7.21 mmol / L.

5. We measure the parameters of blood pressure after eating, mm Hg:

A5 = 142; A6 = 80; A7 = 139; A8 = 80.

6. We calculate the arithmetic mean values, mm Hg:

SAD1avr. = 140; DBP1 avg. = 80.

7. We calculate the correlation coefficient after eating:

K1 = 140 / 80-1.8.

8. Determine the glucose level in the blood after a meal by the formula:

P1 = 0.65 * E ^{1.5 * K1} or according to the table: P = 8.97 mmol / L.

Since the measured fasting blood glucose (P = 7.21 mmol / L) and postprandial glucose (P1 = 8.97 mmol / L) correspond to an acceptable degree of compensation for carbohydrate metabolism disorders, an additional glucose tolerance test may be prescribed to detect possible impaired glucose tolerance.

Example 3

1. During the examination of the patient measured fasting blood pressure, mm Hg:

A1 = 154; A2 = 84; A3 = 156; A4 = 80.

2. We calculate the arithmetic mean values, mm Hg:

SADav. = 155; DBPs. = 82.

3. We calculate the correlation coefficient on an empty stomach:

K = 155/82 = 1.9.

4. Determine the fasting blood glucose by the formula:

P = 0.37 * E ^{1.65 * K} or according to the table: P = 8.51 mmol / L.

5. We measure the parameters of blood pressure after eating, mm Hg:

A5 = 160; A6 = 83; A7 = 160; A8 = 81.

6. We calculate the arithmetic mean values, mm Hg:

SAD1avr. = 160; DBP1 avg. = 82.

7. We calculate the correlation coefficient after eating:

K1 = 160/82 = 1.95.

8. We determine the glucose content in the blood after eating according to the formula P1 = 0.65 * E ^{1.5 * K1} or according to the table: P = 12.11 mmol / L.

Fasting blood glucose (P = 8.51 mmol / L) and postprandial glucose (P1 = 12.11 mmol / L) correspond to poor compensation for carbohydrate metabolism disorders, therefore, an additional study of the biochemical composition of blood is prescribed, since sugar is possible diabetes.

The advantages of the proposed method compared to the prototype include the possibility of non-invasive determination of blood glucose after eating to obtain a glycemic profile, more reasonable identification of carbohydrate metabolism disorders and latent forms of diabetes. A non-invasive method for determining the concentration of glucose in the blood on an empty stomach and after eating with processing the results on a computer can be used as an express method for conducting mass preventive examinations of the population.

Claims (1)

A non-invasive method for determining carbohydrate metabolism disorders, including measuring systolic and diastolic blood pressure sequentially on the patient’s left and right hands, characterized in that systolic and diastolic blood pressure is measured on an empty stomach and after eating, blood glucose in mmol / l on an empty stomach is calculated (P ) and after eating (P1) according to the formulas:
P = 0.37 * E ^{1.65 * K} , where E is a constant, E = 2.71828,
P1 = 0.65 * E ^{1.5 * K1} , where E is a constant, E = 2.71828,
K and K1 are the correlation coefficients, which are defined as the ratio of the arithmetic mean of systolic blood pressure to the arithmetic mean of diastolic blood pressure, measured on both hands of the patient on an empty stomach (K) and after eating (K1), and a violation of carbohydrate metabolism is determined by comparing the obtained indicators P and P1 with diabetes compensation criteria.