Computer Technology in Insulin Based Therapy of Diabetes
description
Transcript of Computer Technology in Insulin Based Therapy of Diabetes
Computer Technology in Insulin Based Therapy
of DiabetesMr. sc. Maja Baretić MDDivision of endocrinologyDepartment of Internal medicine University Hospital Zagreb
Adapted from WHO Diabetes Programme Facts and Figures: www.who.int/diabetes/facts/world_figures/en. Accessed 1 August, 2006.
2000 DIABETES IN THE WORLD
patients< 5,0005,000–74,00075,000–349,000350,000–1,499,0001,500,000–4,999,000> 5,000,000
2030 PREDICTION
patients< 5,0005,000–74,00075,000–349,000350,000–1,499,0001,500,000–4,999,000> 5,000,000
Adapted from WHO Diabetes Programme Facts and Figures: www.who.int/diabetes/facts/world_figures/en. Accessed 1 August, 2006.
Diabetes Mellitus : a group of diseases characterised by high levels of blood glucose resulting from defects in insulin production, insulin action, or both
Consists 2 main types:
1) Type 1 diabetes
2) Type 2 diabetes
Diabetes Mellitus : a group of diseases characterised by high levels of blood glucose resulting from defects in insulin production, insulin action, or both
Consists 2 main types:
1) Type 1 insulin secreting cells destroyed
2) Type 2 diabetes
Diabetes Mellitus : a group of diseases characterised by high levels of blood glucose resulting from defects in insulin production, insulin action, or both
Consists 2 main types:
1) Type 1 insulin secreting cells destroyed
2) Type 2 insufficient insulin action
Why to treat diabetes mellitus?
blindness
kidney failurehaemodialysis
stroke
myocardial
gangreneamputation
nerve damage• In type I acute complication and death
infraction
How to treat diabetes?
Insulin is applied subcutaneously Before application glucose level is
measured Glucose regulation is one of the most
sophisticated ones in the body Impossible to imitate
INFORMATION What is happening with me today? How high is the glucose level now? Am I going to eat a lot? Is my food going to contain many carbohydrates? Am I going to perform an exercise and for how
long? How much insulin should I apply? Which type of insulin should be applied and when? When is the proper time to measure blood glucose
again?
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Algorithmic-based decision support systems
www.nidm.org/HumaLink/Diabetes/ provide set of schemes
by which patient can adjust a therapeutic insulin routine and achieve the desired glycemic control– fully automated mode,
within pre-defined limits
– manual’ recording mode
Algorithmic-based decision support systems
www.nidm.org/HumaLink/Diabetes/ provide set of schemes
by which patient can adjust a therapeutic insulin routine and achieve the desired glycemic control– fully automated mode,
within pre-defined limits
– manual’ recording mode
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Educational tutorials
web sites designed for educational and teaching purposes
AIDA: a freeware diabetes software simulator / modelling program of blood glucose-insulin action + insulin dose & diet adjustment
for education, self-learning & teaching diabetes programmes
www.2aida.net/welcome
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Databases information about diabetic
patient accessible locally, regionally and nationally
used for statistics, research and clinical practice
CroDiabNET founded 1997
firs public health registry where users can input data through www
Databases information about diabetic
patient accessible locally, regionally and nationally
used for statistics, research and clinical practice
CroDiabNET founded 1997
firs public health registry where users can input data through www
http://crodiab.continuum.hr
http://crodiab.continuum.hr
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Applications of information technology in clinical diabetes care
Lehmann E.D. Application of information technology in clinical diabetes care Part 2. Models and education. Medical Informatics, 1997; 22, (1), 1-120
Glucose monitoring
Continuous glucose monitoring tiny sensor inserted under the skin
checks glucose levels sensor stays in for several days transmitter sends information
about glucose levels via radio waves to wireless monitor
pricking a fingertip using a glucose meter that measures the blood sample’s glucose level
Glucose monitoring
Software systems download data to a computer to see patterns and trends in their glucose levels
Send to a physician by email Analyse, store
Insulin pump
delivers insulin continuously into the body
the pump itself: controlsprocessing module
batteries reservoir for
insulin
disposable infusion set:
•short tube with a needle
•tubing system
Artificial pancreas
Science fiction?
Artificial pancreas
Science fiction? Borg?
Artificial pancreas
Science fiction? Borg?
Artificial pancreas =insulin pump + continuous glucose monitoring
closed loop system data from continuous
glucose monitoring blood glucose reading every few minutes
sensor is connected via wire to the insulin pump
blood glucose variation is signalling to the pump how much insulin to deliver
Friedrich M J. Artificial Pancreas May Soon Be a Reality JAMA. 2009;301:1525-1527
Telemedicine
medicine at distance facilitates communication among two or
more medical professionals or among medical professional and patient care
Telemedicine on Croatian islands Croatian Telemedicine Society of the
Croatian Medical Association
Telemedicine Croatia-Japan
Live TV report ( National Japanese TV) about
successful telemedicine activities in cardiology
between National Institute of Health, Osaka, Japan and Makarska, Croatia
www.mef.hr/telmed-MA2002
In 1922 a 14-year-old boy Leonard Thompson, patient with diabetes type 1, was dying from ketoacidosis. He was the first patient
who got insulin in therapy. Without insulin he would
dye in a few days, but the fact that he lived 13 years
more was considered a miracle
“We have data on hand today that suggests that you could get much better diabetes outcomes with the computer taking the lead instead of the person with
diabetes doing it all themselves.”
Aaron Kowalski
research director of the Juvenile Diabetes Research Foundation's Artificial Pancreas Project