High-tech Control: Computer Tools for Diabetes Management

| Sep 1, 1998

Helping space aliens and controlling blood glucose may sound like an odd mix, but in a new educational software program produced by the Starbright Foundation, a non-profit organization, the two work together to help teach kids about diabetes. The program, funded by Eli Lilly & Company, is just one example of the computer software products available to help people of all ages manage their diabetes.

The central character of the Starbright's software, called the Diabetes CD-ROM, is a space alien named Xylo. "Alien Xylo's ship is in pieces," instructs the program, "and the only way to help him get home to his planet, Ragus, is to effectively manage your diabetes throughout the day, collecting pieces of his ship as you go."

Thus begins an interactive educational adventure that models a day in the life of a child with diabetes. Whether it is waking up, going to school, or playing soccer with Xylo, the program teaches kids what they need to do to successfully manage their diabetes.

Not Just for Kids

While the Starbright program is mainly for kids, there are a host of other software programs available to help adults better manage their diabetes. Why do you need a computer to manage your diabetes? You don't. Most people can manage their blood sugar just fine without going high-tech. A computer just makes the job easier.

Most diabetes software work in conjunction with a blood glucose meter. The programs transfer (download) information from the meters and organize and present it in summary form. Using the programs, you can look back at your daily, weekly, monthly, and yearly glucose values at various times of day, such as before bed, before breakfast, after exercise, or any other point in time. You can also create different charts and graphs that illustrate the percentage of your readings that fall above, below, or within your desired target range.

In addition, if you decide to alter your daily routine, most software packages can also help you track the impact on your blood glucose levels. For instance, if you change your workout routine from early morning to after work, you can use the software to compare trends in your post-exercise readings before and after the change in your program.

A relatively new diabetes data management software program called GlucoPilot, designed specifically for the Palm Pilot (a mini, hand-held computer) is making it possible for on-the-spot recording of information like blood glucose readings, injections and carbohydrates. Because of the pocket-size convenience of the Palm Pilot, you can take it with you virtually anywhere, record data throughout the day, analyze it instantly, or store it and later download it to your home computer. The program is completely flexible, meaning that you can design your own charts and tables, and add your own notes. A revised version of the software will soon allow users to download historical information directly from One Touch meters. For more information see http://www.pilot.org/glucorev.het

Sophisticated Meal Planning

In addition to analyzing your blood glucose readings, some software packages also help you to manage your diet. By just typing in what you plan to eat, these programs automatically calculate all your food values, including calories, protein, carbohydrates, total fat, and cholesterol. Some can also create menus (most versions have at least 10,000 food items that you can draw from), produce a shopping list based on recipes or menus chosen, and even calculate your ideal weight and body mass index, as well as your daily energy requirements for weight maintenance, gain or loss. Whether you follow the carbo-counting approach, fat gram counting or the ADA exchange system, this software can save you hours of calculating and record keeping.

While useful for people with either type 1 or type 2 diabetes, most meal planning software programs are especially helpful for those who are newly diagnosed and haven't yet learned how to calculate food values. They are also ideal for people who are looking for help in adding variety to their diet.

A few of the meal-planning software packages available for PC computers include Food Smart ($29.95) from Sasquatch Software Inc. ((604-984-9691 or http://www.food-smart.com) or Diabetes Meal Planner ($59), Managing Diabetes ($59) and Diabetic Nutrition ($39) from NutriGenie ((800) 242-4775 or http://www.users.aol.com/nutrigenie). A very useful and simple meal planning spreadsheet can be downloaded for free from the Children with Diabetes web site (http://www.castleweb.com/diabetes) in the following formats: Microsoft Excel for Windows 95, Microsoft Excel 3.0 or 4.0, Lotus 1-2-3 Version 3 and Quatro Pro 1.0. The spreadsheet calculates grams and calories of carbohydrates, protein and fat based on exchange values.

Fewer options are available for Macintosh users. A very comprehensive Mac program is the Meals 'n Carbs program ($89.95) available from Diabetes Educators Inc. ((888) 30 CARBS or http://www.mealsncarbs.com).

Optimizing with HealthView

An example of one of the more advanced diabetes software products on the market is the Healthview for Diabetes software offered by Health Management Software, Inc. of Roswell, Georgia. HMS President Robert Santoyo says the program allows users to find out how they can optimize their therapy and reduce their medication requirements. Santoyo explains that " with what you're taking, we can figure out how much food you need to eat."

A Virtual Clinic?

In addition to meal planning and analyzing blood glucose levels, your computer may also soon give you access to virtual clinics. According to Vimla Patel, M.D., director of Medical Education at Montreal's McGill University, people with diabetes may soon be able to obtain their test results and other personal health information via the internet.

Working in conjunction with New York's Columbia Presbyterian Hospital, Dr. Patel is currently piloting a program in which individuals can access their own medical history by logging onto a web-based clinical information system (called PATCIS). Once logged on to the system, patients will be able to review their most recent tests and their complete medical charts. The system can also link to a library, where you will be able to look up answers to specific questions like why you feel tired right after taking a dose of insulin, or what your chances are of having a child who develops diabetes.

"This is just the beginning of how the management of conditions like diabetes will become more effective and efficient through technology," says Dr. Patel. "Interactive sites like this will lead the way to more individualized care without the need for face-to-face visits."

Dr. Patel is also involved in another pilot project where special display telephones are being used by individuals to dial in their daily blood glucose and urine test results directly into a health care professional's database. The ultimate goal is to create a system that can then provide almost immediate responses and suggestions to these same individuals.

But will people feel comfortable transmitting their results over the internet? Can confidential information be protected from unauthorized viewers? According to Dr. Patel's research, most individuals who have met and established a trusting relationship with their health care providers feel comfortable transferring personal information over the internet.

As for protecting confidentiality, special software is available to encrypt the information. Once loaded into both your home computer and the health care provider's system, the software allows you to use a password so that only you and your provider can access the information. Medical records, questions and comments could then only be de-scrambled into a readable format by using the secret passwords.

What does this mean for the quality of diabetes care in the future? At a minimum, people with diabetes can expect better access to the information they need to manage their diabetes, which should help to make life a little less uncertain and a little more convenient. By examining your readings in advance, you will be more prepared to discuss progress and problems with your health care team.

According to Alastair T. Gordon, president of the Islet Foundation in Toronto, the use of computers has already helped in this regard. "Today computers are extremely valuable in that they provide links to important information," he said. "I think the future is going to offer even greater access to health care providers and to getting questions answered."

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Categories: Blood Glucose, Blood Sugar, Diabetes, Diets, Food, Insulin, Kids & Teens, Software, Type 2 Issues

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