COMPUTER-ASSISTED DIABETES CARE - A 6-YEAR RETROSPECTIVE

Over the past 6 years we have designed a number of computer-based prot otypes for the provision of therapeutic advice and the generation of g lycaemic predictions in insulin-dependent (type 1) diabetic patients. In this paper we provide an overview of some of this work, and describ e our experiences in trying to develop such methods for clinical use. We review, as an example,a model of the glucoregulatory system which h as been developed for patient and medical staff education about type 1 diabetes mellitus, as well as possibly for therapeutic use. Using ind ividualised parameter values the predictions of the model can be appli ed to generate 24-h simulations of patient blood glucose profiles. Pre vious preliminary retrospective validation work performed with this mo del has revealed a mean predictive accuracy for blood glucose simulati ons of approximately 2 mmol/l. Conceptual limitations of such modellin g approaches are considered. We comment that such ' mechanistic ' mode ls may lack the necessary sophistication and flexibility to represent the complexity of the human glucoregulatory system and the challenges it has to face. Although such methodologies may therefore not be suita ble for safe and effective application in routine clinical practice, w e conclude that the evolution of such a system for demonstration/educa tional purposes could have widespread clinical utility as an interacti ve teaching tool.