Insulin algorithms in the self-management of insulin-dependent diabetes: the interactive 'Apple Juice' program.

The 'Apple Juice' program is an interactive diabetes self-management program which runs on a lap-top Macintosh Powerbook 100 computer. The dose-by-dose insulin advisory program was initially designed for children with insulin-dependent (type 1) diabetes mellitus. It utilizes several different insulin algorithms, measurement formulae, and compensation factors for meals, activity, medication and the dawn phenomenon. It was developed to assist the individual with diabetes and/or care providers, in determining specific insulin dosage recommendations throughout a 24 h period. Information technology functions include, but are not limited to automated record keeping, data recall, event reminders, data trend/pattern analyses and education. This paper highlights issues, observations and recommendations surrounding the use of the current version of the software, along with a detailed description of the insulin algorithms and measurement formulae applied successfully with the author's daughter over a six year period.

[1]  Albisser Am Intelligent instrumentation in diabetic management , 1989 .

[2]  G. Bolli,et al.  The "dawn phenomenon"--a common occurrence in both non-insulin-dependent and insulin-dependent diabetes mellitus. , 1984, The New England journal of medicine.

[3]  J. Skyler,et al.  Algorithms for Adjustment of Insulin Dosage by Patients Who Monitor Blood Glucose , 1981, Diabetes Care.

[4]  W. Clarke,et al.  Overnight Basal Insulin Requirements in Fasting Insulin-dependent Diabetics , 1980, Diabetes.

[5]  N. White,et al.  Influence of Growth Hormone on Overnight Insulin Requirements in Insulin-dependent Diabetes , 1985, Diabetes.

[6]  Norman Fleischer,et al.  The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. , 1993 .

[7]  M. Rendell,et al.  The Dawn Phenomenon, an Early Morning Glucose Rise: Implications for Diabetic Intraday Blood Glucose Variation , 1981, Diabetes Care.

[8]  T. Deutsch,et al.  Application of computers in diabetes care--a review. I. Computers for data collection and interpretation. , 1995, Medical informatics = Medecine et informatique.

[9]  A. M. Albisser,et al.  Insulin dosage adjustment using manual methods and computer algorithms: A comparative study , 2006, Medical and Biological Engineering and Computing.

[10]  T. Deutsch,et al.  Application of computers in diabetes care--a review. II. Computers for decision support and education. , 1995, Medical informatics = Medecine et informatique.

[11]  R. Turner,et al.  Continuous infusion of glucose with model assessment: measurement of insulin resistance and β-cell function in man , 1985, Diabetologia.

[12]  W. Kerner,et al.  Studies on the pathogenesis of the dawn phenomenon in insulin-dependent diabetic patients. , 1984, Metabolism: clinical and experimental.

[13]  E D Lehmann,et al.  Computer assisted diabetes care: a 6-year retrospective. , 1996, Computer methods and programs in biomedicine.

[14]  E. Lehmann The diabetes control and complications trial (DCCT): a role for computers in patient education? , 1994 .