Insulin dosage adjustment using manual methods and computer algorithms: A comparative study

The paper presents a three-way comparative study of the responses of computer-simulated diabetic patients to intervention for insulin dosage adjustment either by a diabetologist according to conventional methods or by the patient himself according to either recommended manual methods or a newly developed computerimplementable algorithm. In all cases, insulin dosage adjustment improved glycaemic control. However, the new computer algorithm described in this report was superior both in respect to the speed of improving diabetes control and the avoidance of undesirable hypoglycaemia. We conclude, on the basis of our simulations, that a computer may advantageously be used to accept daily blood glucose estimates and recommend changes in insulin therapy, that these dosage changes should improve glycaemic control (as assessed by reductions in both the mean premeal glycaemia and its variability), and finally that the development of a portable insulin dosage microcomputer device can provide both the patient having diabetes mellitus and his physician with a new and unique method for significantly improving conventional insulin therapy.