**2.2 Glucose and insulin measurements**

448 Biomedical Science, Engineering and Technology

screening eye examinations, thereby reducing the long time wait for diabetic patients to receive eye examinations. Common activities in software engineering approach for retinopathy include single or multi-modality retinal image registration, fusion, vessel pattern recognition, arteries & veins identification, and vessel diameter measurement. These methods play a major role in the development of better methods of diagnosing and treating diabetic retinopathy. Fusing the multi-modality retinal images, which usually requires intensive computational effort, is a very challenging problem because of the possible vast

This chapter is going to present a novel approach of retinal image fusion. Control points are detected at the vessel bifurcations using adaptive exploratory algorithm. Mutual-Pixel-Count (MPC) maximization based heuristic optimization adjusts the control points at the sub-pixel level. The iteration stops either when MPC reaches the maximum value, or when the maximum allowable loop count is reached. A refinement of the parameter set is obtained at the end of each loop, and finally an optimal fused image is generated at the end of the iteration. By locking the multi-modality retinal images into one single volume, the algorithm allows ophthalmologists to match the same eye over time to get a sense of disease progress and pinpoint surgical tools to increase accuracy and speed of the surgery. The new algorithm can be easily expanded to human or animals' 3D eye, brain, or body image

Diabetes mellitus type 2 is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency [3]. The pathophysiology of Type 2 diabetes mellitus involves impaired insulin secretion, and impaired insulin action in regulating glucose and fatty acid metabolism in the liver, skeletal muscle, and adipose tissue. Many individuals with Type 2 diabetes mellitus have hypertension and perturbations of lipoprotein metabolism, as well as other manifestations of the insulin resistant syndrome. In addition to the risk for development of diabetes - specific complications of retinopathy, Type 2 diabetes mellitus is recognized as a substantial risk factor for cardiovascular disease [4]. It is recommended by the National Diabetes Data Group that diagnosis of diabetes mellitus

2. Two two-hour postprandial plasma glucose (2hrPPG) readings of 200 mg/dL (11.1

Fasting plasma glucose was selected as the primary diagnostic test because it predicts

A mammalian Fem1 gene family, encoding homologs of fem-1, has been characterized and consists of at least three members in the mouse, designated Fem1a, Fem1b, and Fem1c; these have highly conserved homologs in humans, designated FEM1A, FEM1B, and FEM1C, respectively. Mammalian homologs of two other nematode sex determination genes, tra-2 and tra-3, have recently been implicated in glucose homeostasis and type 2 diabetes mellitus. In producing susceptibility to type 2 diabetes mellitus, NIDDM1 is known to interact with a gene, whose identity is unknown, on human chromosome 15 near the CYP19 locus at 15q21.3 [6]. This is near 15q22, where FEM1B, the human homolog of mouse Fem1b,

1. Two fasting plasma glucose levels of 126 mg/dL (7.0 mmol/L) or higher;

3. Two casual glucose readings of 200 mg per dL (11.1 mmol per L) or higher.

adverse outcomes (e.g., retinopathy) and is easy to perform in a clinical setting.

content change and non-uniform distributed intensities of the involved images.

registration and fusion.

be based on [5]

localizes [7].

**2. Diabetes mellitus type 2 and fem1b gene** 

**2.1 Diabetes mellitus type 2 occurrence and its diagnosis** 

mmol/L) or higher after a glucose load of 75 g;

Blood glucose from tail vein was measured using an OneTouch FastTake Glucometer. Insulin was measured from plasma, tissue extracts, or cell supernatants using the Rat (Mouse) Sensitive Insulin radioimmunoassay (RIA) kit and the manufacturer's instructions. For the intraperitoneal glucose tolerance test (iPGTT), intraperitoneal insulin tolerance test (iP-ITT), and acute-phase glucosestimulated insulin secretion (A-GSIS) test, there were 12 animals in each group (12 male homozygous Fem1b-KO, 12 male wild-type controls, 12 female homozygous Fem1b-KO, and 12 female wild-type controls), aged 3 to 4 months. The arginine-stimulated insulin secretion test compared eight Fem1b-KO homozygous males with eight wild-type males, aged 6 months. D-Glucose (200 mg/ml) was administered at 2 mg/g body weight by intraperitoneal injection [8]. Tail vein blood was sampled for blood glucose determination from nonsedated animals before and at 15, 30, 60, and 120 min after glucose administration.
