MODERN MANAGEMENT OF CHILDHOOD DIABETES - A ROLE FOR COMPUTERIZED DEVICES

Technology is increasingly relevant in everyday life and it can be ver y interesting to apply it also in the field of diabetes as it can be o ne way of ensuring better care. In the Diabetes Control and Complicati ons Trial, the intensively treated patients were seen fortnightly in h ospital and contacted even more frequently by telephone during the day as well as at night. For these reasons, health reforms are undergoing a radical change in an attempt to reduce the spiraling costs of healt h care provision. Therefore, it can be useful to use information techn ology (IT) in diabetes care. The European Federation for Medical Infor matics recently established some Special Issues to advance TT initiati ves that may be able to address the problem of adjusting the insulin d ose and controlling blood glucose (BG) levels, as well as assisting in the provision of modern-day diabetes care. The Special Issues can be classified under the following headings: databases, algorithms, decisi on support, models and education. It can be useful to develop a protot ype computer system that can be applied to different areas of clinical diabetes care: computerized out-patients' clinical databases that sto re patients' clinical and biochemical data; statistical and graphical analysis programs that help the clinician; dietary analysis programs w hich examine food composition and dietary exchanges and help devise me al plans; hand-held insulin dosage adjustment computers that advise pa tients on a day-by-day or even meal-by-meal basis; expert systems and question and answer programs for patients' education, and finally game s for children. These systems have the potential to be useful tools in many aspects of diabetes care but their utilization by the vast major ity of the health care community has been extremely limited. Nonethele ss, computers cannot substitute for the pediatric diabetes team, which remains the major determinant for better care of diabetes in children and adolescents.