PRELIMINARY EXPERIENCE OF THE DIAS COMPUTER-MODEL IN PROVIDING INSULIN DOSE ADVICE TO PATIENTS WITH INSULIN-DEPENDENT DIABETES

The Diabetes Advisory System (DIAS) is a model of human glucose metabo lism which predicts hourly blood glucose concentrations and provides a dvice on insulin dose. Its ability to provide appropriate advice was a ssessed in 20 well-controlled IDDM patients (mean (SD) age 38 (11), du ration 17 (9) years; HbA1 8.8 (0.9)%, reference range 5.4-7.6%). Patie nts recorded blood glucose measurements, insulin dose and food intake for 4 days. These data were used to generate insulin dose advice by bo th DIAS and a diabetes specialist nurse. Patients were then allocated to follow either DIAS or nurse advice for a further 4 days. There was no significant difference in mean recorded blood glucose values or fre quency of reported hypoglycaemia between the DIAS and nurse groups eit her before or after insulin dose adjustment. The DIAS model, however, generated significantly lower insulin dose advice than the nurse (medi an (range)% change in insulin dose: DIAS group - 13.3% (- 25.0 to + 11 .6) versus nurse group 0% (- 8.7 to + 2.5), P < 0.05). We conclude tha t, in the patients studied, DIAS provided insulin dose advice which ma intained good short term control of diabetes, despite significant redu ctions in dose in some cases. (C) 1998 Elsevier Science Ireland Ltd. A ll rights reserved.