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7. Modeling blood glucose dynamics.

Author

Gatewood, Laël C., Ackerman, Eugene, Rosevear, John W., and Molnar, George D.

Abstract

For the past several years, various simulations of the blood glucose regulatory system have been performed. Mathematical models of such a system have enabled data reduction, diagnostic classification, hypothesis testing and design of critical experiments. These mathematical models, which simulate the behavior of the real physiological systems, are in turn simulated using various digital and analog computer techniques. A single basic model relating blood glucose and plasma insulin has been shown to adequately describe responses of the glucose regulatory system to various challenge stimuli. Specific examples discussed included responses to an oral glucose tolerance test and an intravenous insulin infusion test. The significance of the model conformations to such tests is discussed in view of the goals of modeling and the extension of knowledge of blood glucose dynamics. Although this model is a highly oversimplified representation of the physiological control system, it has been used successfully in a variety of applications. [ABSTRACT FROM AUTHOR]

Published
1970
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19. Urine Glucose Analyses During Continuous: Blood Glucose Monitoring

Author

Service, F. John, Molnar, George D., and Taylor, William F.

Abstract

Studies in ambulatory, fed diabetic patients and normal subjects, with continuous in vivo blood glucose analysis for 48-hour periods, have permitted an examination of the relationship between simultaneous levels of blood and urinary glucose. There is a significant correlation between the blood glucose level and the urinary glucose level measured quantitatively for the period of observation. Semiquantitative determination of urinary glucose with the use of colorimetric test paper (Tes-Tape) on second-voided preprandial urine specimens is at best a rough indication of the prevailing blood glucose level and in some instances may be misleading. Semiquantitative glucose analysis of first-voided and second-voided urine specimens, bracketing a urine collection period, provides a clinically useful estimate of the urinary glucose level during the collection period.

Published
1972
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22. Idiopathic Orthostatic Hypotension

Author

Schirger, Alexander, Hines, Edgar A., Molnar, George D., and Thomas, Juergen E.

Abstract

Six patients with idiopathic orthostatic hypotension were studied for the effect and mode of action of 9-alpha-fluorohydrocortisone. In 5 patients satisfactory symptomatic control of the hypotension was achieved. In 1 patient it was twice demonstrated that the rise of blood pressure obtained within 48 hours after starting treatment with 9-alpha-fluorohydrocortisone was accompanied by increased sodium retention and potassium excretion, as measured by metabolic balance studies. On long-term observation, while the improvement in blood pressure was maintained, no major alterations in water and electrolyte balance persisted.

Published
1962
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24. Recent Advances in Management of Functioning Islet Cell Tumor

Author

Ferris, Deward O., Molnar, George D., Schnelle, Norbert, Jones, James D., and Moffitt, Emerson A.

Abstract

In nine patients who had insulinomas, celiac arteriography was found to be useful in locating the tumor, and serial measures of the blood glucose level proved helpful in monitoring the patient during surgery; in each patient, blood glucose levels rose after the tumor was removed. An increase in blood glucose concentration during the first hour after removal of a portion of the pancreas, or in some instances during the second succeeding half hour, was consistent with the assumption that other insulinomas were not left behind.

Published
1972
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25. Circulating Glucose and Insulin in Surgery for Insulomas

Author

Schnelle, Norbert, Molnar, George D., Ferris, Deward O., Rosevear, John W., and Moffitt, Emerson A.

Abstract

Serial blood glucose and plasma immunoreactive insulin measurements during operations for insulomas were clinically useful in six patients. Mean blood glucose concentration rose by 40 mg/100 ml/hr during the initial 30 minutes after tumor removal, when no further functioning insuloma remained in situ. This information was available to the surgeon with a 15-minute delay. Insulin levels determined subsequently confirmed the assumptions based on glucose measurements. In addition to helping the surgeon to resect the least amount of pancreas necessary, these measurements enhanced the patient's safety from potentially dangerous hypoglycemia during anesthesia. Preoperative celiac arteriograms were done in five patients. They were helpful in localizing tumors in two patients and were retrospectively recognized to have correctly indicated the location of the tumor in a third patient.

Published
1971
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