WO2005081119A2 - Interactive diabetes education system - Google Patents

Interactive diabetes education system Download PDF

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Publication number
WO2005081119A2
WO2005081119A2 PCT/ZA2005/000038 ZA2005000038W WO2005081119A2 WO 2005081119 A2 WO2005081119 A2 WO 2005081119A2 ZA 2005000038 W ZA2005000038 W ZA 2005000038W WO 2005081119 A2 WO2005081119 A2 WO 2005081119A2
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Prior art keywords
blood glucose
insulin
user
glucose level
exercise
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PCT/ZA2005/000038
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French (fr)
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WO2005081119A8 (en
Inventor
Edward Henry Mathews
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Edward Henry Mathews
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Publication of WO2005081119A8 publication Critical patent/WO2005081119A8/en

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    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B5/00—Electrically-operated educational appliances
    • G09B5/02—Electrically-operated educational appliances with visual presentation of the material to be studied, e.g. using film strip
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B19/00—Teaching not covered by other main groups of this subclass

Definitions

  • THIS INVENTION relates to a diabetes educational system. It also relates in particular to a system to graphically simulate the effects that food, exercise, insulin and counter regulation hormones have on blood glucose levels; and to a method of operation of such a diabetes educational system.
  • Equivalent Teaspoon Sugar means an energy unit used for quantifying energy in food and energy usage in exercise.
  • ets can also be used to quantify energy being expended during exercise by relating the energy to the effective energy available in a teaspoon sugar, ets can also be used to express any quantity of energy e.g. the blood glucose energy in the blood or the amount of glycogen energy stored in the liver.
  • insulin includes within its scope any blood sugar regulatory substance.
  • diabetes or diabetic refers to Type 1 diabetes or Type 1 diabetic respectively unless otherwise stated.
  • IDM Insulin Dependant Diabetes Mellitus
  • the main objective of this system is to show the effects that food, exercise and insulin have on blood glucose levels for the specific person. By playing around and changing the magnitudes of these factors of said system the diabetic will soon gain valuable insight into the blood glucose control problem. Diabetes can be difficult to understand for children and said invention will provide a learning environment that is easy and fun to use.
  • said system may improve blood glucose level control thereby reducing occurrences of hypoglycemia and hyperglycemia and also lowering the risk of both short- and long-term diabetes complications.
  • Figure 1 shows a possible layout for a means to capture person specific data.
  • Figure 2 shows the simulation indicating the relation between blood glucose level, food, exercise, insulin, counter regulation and also several options.
  • Figure 3 shows the possible layout for a means to capture blood glucose related parameters.
  • Figure 4 shows the possible layout for a means to select main food or beverage category from which foodstuffs can be selected.
  • Figure 5 shows the possible layout of the typical sub categories resulting from the selection of a main food category from which a specific food or beverage item can be selected from.
  • Figure 6 shows the possible layout for quantity selection of a specific food or beverage item and also indicating calculated nutritional values.
  • Figure 7 shows the possible layout for selection of exercise type.
  • Figure 8 shows the possible intereface for setting the duration of exercise.
  • Type 1 diabetics have to control their blood glucose levels by administering insulin while taking into account the effects that food, exercise, stress and other influential factors have on blood sugar levels.
  • Said invention illustrates to the user by interaction how these factors influences blood glucose levels.
  • FIG. 2 shows the basic layout of the educational device.
  • the centre 21 is the blood glucose level.
  • the following two factors cause an increase in blood glucose levels: Energy eaten 3 (food) and Energy from liver 20 (glycogen released into blood as glucose in response to the hormone glucagon).
  • the following two factors reduce the blood glucose level: Energy stored 9 (Glucose being stored as glycogen in response to the hormone insulin) and Exercise energy expended 10 (glucose is expended for energy requirements).
  • the insulin factor 6 influences the blood glucose level indirectly by allowing glucose to be stored 9, glucose to be expended for energy 10 and may cause the counter regulation (energy from the liver) to increase blood glucose levels. All of the abovementioned factors have both a sensitivity value (e.g.
  • the simulation model uses these maximum values for boundary values in its calculations.
  • the sensitivity values are either measured on the specific diabetic user or approximated from the body characteristics supplied to customize the simulation for the specific diabetic user.
  • the following three factors can directly be altered by the user: efs eaten 3 l admin 6 and ete ex l3 and therefore an input means is provided by which the user can alter these values by either dragging the factor-arrows, entering a numerical value, by selecting items from menus or lists (storage means is provided) that indirectly alters these factors or any other means enabling the alteration of these factors.
  • the other three factors namely energy stored 7, exercise energy expended 10 and energy from live 20 are related to the three input factors and the blood glucose level.
  • Said invention also comprises a processing means enabling the calculation of blood glucose values and the interaction between the different factors.
  • the blood glucose value can be calculated by using the following simplified equation: exAct ) -J ets where ES congestion ew is the calculated blood glucose value and ES, mV is the initial blood glucose value entered by user. f ets is a person specific factor relating the amount of glucose in the blood to a blood glucose concentration or blood glucose level.
  • the blood glucose value is calculated each time one of the factors changes.
  • the indirect factors are calculated in response to changes of the other factors or the blood glucose level itself.
  • Two control levels for the blood glucose level is specified namely BS c rolLOW and BS controlHIGH .
  • This value 2,3 can be altered by using sai ⁇ input means to enter a value, drag the arrow 3 to change it's magnitude or by making a selection of items from the food database 22.
  • Figure 4 shows a typical interface for selection of main food catergories from the food database.
  • Figure 5 shows a typical interface for showing sub-categories and specific food or beverage items from the food database.
  • Figure 6 shows a typical layout for selecting number of portions of a specific food item from the food database.
  • An increase in energy eaten will result in a rise in blood glucose level 21.
  • Carbohydrates from meals are broken down to glucose and then absorbed by the digestive system into the blood. This results in an increase in the blood glucose concentration or blood glucose level. It can be shown that there is a good linear relationship between ets intake and rise in blood glucose level. A person specific linear constant can be measured for the specific diabetic user.
  • Insulin This value 5, 6 can be altered by using said input means to enter a value or drag the arrow 6 to change its magnitude. Insulin is quantified in U. Insulin is used for two purposes: to promote the storage of glucose in storage cells as glycogen (i.e. in the liver) or to promote the utilization of glucose for the energy purposes of living cells (i.e. for metabolism, energy for exercise). The following two factors are therefore dependent upon the insulin value: energy stored 9 and exercise energy expended 10. When a person is not exercising, insulin is used primarily to store glucose 9 (except for basal insulin which is constantly used for utilization of glucose energy by cells). There is an almost linear relationship between the number of short acting insulin units administered and the drop in blood glucose level.
  • a person specific linearity constant fin sN orm can be measured for the specific diabetic.
  • Change of insulin sensitivity value Insulin sensitivity increases (or insulin resistance decreases) considerably when exercising. The more intense the exercise, the greater the increase in insulin sensitivity. This means that less insulin is necessary to utilize the glucose energy while exercising, than when utilizing glucose for normal metabolism energy. Insulin resistance can increase with up to a factor 4 while exercising. This means that the basal insulin is more effective and can therefore be seen as more "effective insulin" being present in the blood while exercising.
  • f insS ⁇ ns is the insulin sensitivity change factor for changes due to exercise. All energy levels in above equations are normalized to the same time period. The above equation can now be used to calculate the effective insulin available during exercise. Remember that the effective insulin can be more than the actual insulin. Effective insulin can only be used for energy expenditure for exercise and not for storage of glucose. Insulin e ffective : ⁇ (insulin basa ⁇ + insulin adm inistered) * f insSens etSexAct ⁇ lnSUHn e ffective%xAct%ts (3)
  • insulin will first be used to utilize energy (effective insulin is used) and the rest of the insulin (actual insulin) is used to store glucose. It is risky to inject too much insulin during exercise, because both insulin and exercise lower the blood glucose level therefore increasing the risk of hypoglycemia. It is also risky to start an exercise session with a low or normal bloo ⁇ giucuse ⁇ eve ⁇ even when no insulin has been administered. The diabetic should keep a carbohydrate rich snack or beverage close in case hypoglycemia does occur.
  • Exercise attempted and or exercise energy expended The relationship between these two factors was discussed above in the insulin section/
  • the exercise attempted 15 value can be altered by using said input means to enter a value, drag the arrow to change its magnitude or by selecting exercises from the exercise database.
  • the exercise energy expended 10 (actual exercise energy) factor cannot be changed directly by the user. This factor depends on if enough effective insulin is present. If not - then this quantity will be less than the exercise attempted and will also cause the energy from liver factor 20 to increase.
  • Figure 7 shows a typical interface for selecting different types of exercises while figure 8 shows an interface for setting the duration of said interface. The longer the duration or the more a person'weighs or the higher the intensitiy of the exercise, the more ets energy will be expended.
  • the main function of this factor is to counter-regulate low blood glucose levels (hypoglycemia). The user cannot directly alter this factor. When too much insulin is injected, or too much exercise energy is being expended or when there is not enough glucose in the blood the pancreas will secrete glucagon. This will trigger glycogen stored in the liver and other cells to be released as glucose for energy 20. There are various threshold values. Although for healthy persons a blood glucose level of 4mmol/l is normal, the counter regulation system will only start to make considerable efforts to increase blood glucose levels when blood glucose levels falls below 3.5 mmol/l. Here glucagon will be released.
  • the counter regulation of any person has a maximum ability 19. This is related to the amount of glycogen that can be stored and also to the general condition of the counter regulation system of the specific diabetic. If a person has been a diabetic for a few years, his/her liver may have undergone some damage, which decreases its counter regulation ability 20. This maximum counter regulation value quantme ⁇ in eis is snow ⁇ as a line 19. This value can temporarily decrease further under the influence of alcohol, which suppresses the blood glucose counter regulation system.
  • the system will comprise of an input means to enter or select several parameters needed for the simulation of the blood glucose level.
  • Figure 1 shows the parameters that need to be set before the initiation of the simulation are: ⁇ Gender, Height, Weight, Age ⁇ Activity level (for daily energy requirement): Low, Normal, High, Weight Loser ⁇ Desired blood glucose level: Target blood glucose level ⁇ Status of diabetes: Non diabetic, Type 1 -diabetic and duration thereof ⁇ Insulin sensitivity (f, nS Norm)'- Decrease in blood glucose level per unit insulin injected. It can be measured by injecting insulin, measuring the decrease in blood glucose level and then dividing by the number of insulin units injected.eld Decrease in bloodsug ⁇ r level r . , ..
  • ⁇ ets sensitivity (f ea t e n): Increase in blood glucose level per ets ingested. It can be measured by ingesting a meal and measuring the increase in blood glucose level and then dividing the increase with the ets quantity of the meal. The ets quantity in the meal can be calculated using the following equation: . _ Increase in bloodsugar level r .. .. , ..
  • Figure 2 shows the possible layout of the blood glucose simulation system.
  • the simulated blood glucose level 21 is displayed. It is dependant on the parameter values 3, 6, 9, 10, 15 and 20.
  • the blood glucose level is predicted as follows. The user first selects a current blood ' glucose level (BSj n ⁇ t) and desired blood glucose level (BSdesir ed )-
  • the current blood glucose level is any value before a meal, exercise or insulin injection.
  • the diabetic user can then change the values of parameters indicated. All parameters except energy stored 9, energy released 16 and exercise energy expended 12 can be changed by merely dragging or pushing arrows up or downward or by using the input means of said system to change these values.
  • the blood glucose level is then calculated using the equations mentioned earlier.
  • the user can learn the following from this educational device: ⁇ How much insulin should be administered for a specific meal; ⁇ How much additional insulin should be administered for high blood glucose level; ⁇ How much additional carbohydrates in necessary to raise low blood glucose levels to normal; Q How blood glucose levels will respond to exercise; ⁇ How the counter regulation system works; and ⁇ How any combination of food, exercise, insulin, high or low Dioo ⁇ glucose levels should be treated.
  • the advantages are therefore: ⁇ Less occurrences of hypo- and hyperglycemia; ⁇ Better blood glucose control; ⁇ Better comprehension of diabetes by the diabetic; ⁇ Reduced risk of diabetes complications due to poor blood glucose control.

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Abstract

Said invention relates to an educational tool teaching diabetics the dynamics involved in blood glucose level control needed for managing Insulin Dependant Diabetes Mellitus (IDDM). Said system graphically simulates the effects that food, exercise, insulin, counter regulation hormones etc. have on the blood glucose level. Certain parameters are measured on the diabetic user and used by said tool to customize these blood sugar level simulations for the specific user. The system shows the diabetic user a good approximated effect caused by the user changing parameters on the system. Invention provides a training ground where diabetics can simulate certain scenarios to see how they can correct a high or low blood glucose level. The simulation model used uses the ets (Equivalent Teaspoons Sugar)-concept. Good blood glucose control requires discipline, experience and time. Said educational system aims to speed up the learning process. It also leads to improved blood glucose control and reduces the occurrences of hypoglycemia or hypoglycemia.

Description

INTERACTIVE DIABETES EDUCATION SYSTEM
THIS INVENTION relates to a diabetes educational system. It also relates in particular to a system to graphically simulate the effects that food, exercise, insulin and counter regulation hormones have on blood glucose levels; and to a method of operation of such a diabetes educational system.
In this specification, the term Equivalent Teaspoon Sugar (ets) means an energy unit used for quantifying energy in food and energy usage in exercise.
Furthermore ets can also be used to quantify energy being expended during exercise by relating the energy to the effective energy available in a teaspoon sugar, ets can also be used to express any quantity of energy e.g. the blood glucose energy in the blood or the amount of glycogen energy stored in the liver.
Furthermore, in this specification, the term insulin includes within its scope any blood sugar regulatory substance.
Furthermore, in this specification, the term diabetes or diabetic refers to Type 1 diabetes or Type 1 diabetic respectively unless otherwise stated.
OBJECTS AND ADVANTAGES
Insulin Dependant Diabetes Mellitus (IDDM) requires that blood sugar levels be controlled by balancing the increasing effect that food intake has on the blood glucose level with the lowering effect that insulin and exercise have on the blood glucose level. This is a difficult concept to understand and the magnitudes that any of these factors have on the blood glucose level are often unknown and therefore further complicate the control of blood glucose levels.
The main objective of this system is to show the effects that food, exercise and insulin have on blood glucose levels for the specific person. By playing around and changing the magnitudes of these factors of said system the diabetic will soon gain valuable insight into the blood glucose control problem. Diabetes can be difficult to understand for children and said invention will provide a learning environment that is easy and fun to use.
By increasing the knowledge of said diabetic user, said system may improve blood glucose level control thereby reducing occurrences of hypoglycemia and hyperglycemia and also lowering the risk of both short- and long-term diabetes complications.
BRIEF DESCRIPTION OF DRAWINGS
Figure 1 shows a possible layout for a means to capture person specific data.
Figure 2 shows the simulation indicating the relation between blood glucose level, food, exercise, insulin, counter regulation and also several options.
Figure 3 shows the possible layout for a means to capture blood glucose related parameters.
Figure 4 shows the possible layout for a means to select main food or beverage category from which foodstuffs can be selected.
Figure 5 shows the possible layout of the typical sub categories resulting from the selection of a main food category from which a specific food or beverage item can be selected from.
Figure 6 shows the possible layout for quantity selection of a specific food or beverage item and also indicating calculated nutritional values. e
Figure 7 shows the possible layout for selection of exercise type.
Figure 8 shows the possible intereface for setting the duration of exercise.
DETAILED DESCRIPTION
Type 1 diabetics have to control their blood glucose levels by administering insulin while taking into account the effects that food, exercise, stress and other influential factors have on blood sugar levels. Said invention illustrates to the user by interaction how these factors influences blood glucose levels.
All energy units will be quantified in terms of ets. Figure 2 shows the basic layout of the educational device. In the centre 21 is the blood glucose level. The following two factors cause an increase in blood glucose levels: Energy eaten 3 (food) and Energy from liver 20 (glycogen released into blood as glucose in response to the hormone glucagon). The following two factors reduce the blood glucose level: Energy stored 9 (Glucose being stored as glycogen in response to the hormone insulin) and Exercise energy expended 10 (glucose is expended for energy requirements). The insulin factor 6 influences the blood glucose level indirectly by allowing glucose to be stored 9, glucose to be expended for energy 10 and may cause the counter regulation (energy from the liver) to increase blood glucose levels. All of the abovementioned factors have both a sensitivity value (e.g. change in blood glucose value per unit ets energy) and a maximum value (e.g. a maximum amount of ets energy that can be stored). The simulation model uses these maximum values for boundary values in its calculations. The sensitivity values are either measured on the specific diabetic user or approximated from the body characteristics supplied to customize the simulation for the specific diabetic user.
Figure imgf000005_0001
Figure imgf000006_0002
The following three factors can directly be altered by the user: efseaten 3 ladmin 6 and eteex l3 and therefore an input means is provided by which the user can alter these values by either dragging the factor-arrows, entering a numerical value, by selecting items from menus or lists (storage means is provided) that indirectly alters these factors or any other means enabling the alteration of these factors. The other three factors namely energy stored 7, exercise energy expended 10 and energy from live 20 are related to the three input factors and the blood glucose level.
Said invention also comprises a processing means enabling the calculation of blood glucose values and the interaction between the different factors. The blood glucose value can be calculated by using the following simplified equation:
Figure imgf000006_0001
exAct ) -J ets where ES„ewis the calculated blood glucose value and ES,mV is the initial blood glucose value entered by user. fets is a person specific factor relating the amount of glucose in the blood to a blood glucose concentration or blood glucose level. The blood glucose value is calculated each time one of the factors changes.
The indirect factors are calculated in response to changes of the other factors or the blood glucose level itself. Two control levels for the blood glucose level is specified namely BSc rolLOW and BScontrolHIGH .
The different factors and how they influence the blood glucose value and each other will be discussed next. Energy Eaten: This value 2,3 can be altered by using saiα input means to enter a value, drag the arrow 3 to change it's magnitude or by making a selection of items from the food database 22. Figure 4 shows a typical interface for selection of main food catergories from the food database. Figure 5 shows a typical interface for showing sub-categories and specific food or beverage items from the food database. Figure 6 shows a typical layout for selecting number of portions of a specific food item from the food database. An increase in energy eaten will result in a rise in blood glucose level 21. Carbohydrates from meals are broken down to glucose and then absorbed by the digestive system into the blood. This results in an increase in the blood glucose concentration or blood glucose level. It can be shown that there is a good linear relationship between ets intake and rise in blood glucose level. A person specific linear constant can be measured for the specific diabetic user.
Insulin: This value 5, 6 can be altered by using said input means to enter a value or drag the arrow 6 to change its magnitude. Insulin is quantified in U. Insulin is used for two purposes: to promote the storage of glucose in storage cells as glycogen (i.e. in the liver) or to promote the utilization of glucose for the energy purposes of living cells (i.e. for metabolism, energy for exercise). The following two factors are therefore dependent upon the insulin value: energy stored 9 and exercise energy expended 10. When a person is not exercising, insulin is used primarily to store glucose 9 (except for basal insulin which is constantly used for utilization of glucose energy by cells). There is an almost linear relationship between the number of short acting insulin units administered and the drop in blood glucose level. Again a person specific linearity constant finsNorm can be measured for the specific diabetic. In the event that a person is exercising the following is important: Change of insulin sensitivity value: Insulin sensitivity increases (or insulin resistance decreases) considerably when exercising. The more intense the exercise, the greater the increase in insulin sensitivity. This means that less insulin is necessary to utilize the glucose energy while exercising, than when utilizing glucose for normal metabolism energy. Insulin resistance can increase with up to a factor 4 while exercising. This means that the basal insulin is more effective and can therefore be seen as more "effective insulin" being present in the blood while exercising. The increase in "effective insulin" is calculated using the following function: fi ssen ^ t∞ etsexAct < 2; (2) finsSens ~^ + etSeχAct-{minsSens~1 V{" l energy Ex~2) for 2 <= etSexAct <= m n rgyEx, r fiπsSens =^ ' °'" &*SexAct > menergyEx where menergyEx is the energy quantified in ets for a specific person (of a certain weight) performing a very high intensity exercise such as running at 20km/h and e SexAct is the actual energy being expended during the specific exercise being performed. finsSβns is the insulin sensitivity change factor for changes due to exercise. All energy levels in above equations are normalized to the same time period. The above equation can now be used to calculate the effective insulin available during exercise. Remember that the effective insulin can be more than the actual insulin. Effective insulin can only be used for energy expenditure for exercise and not for storage of glucose. Insulineffective:~(insulinbasaι+ insulinadministered) * finsSens etSexAct ~ lnSUHneffective%xAct%ts (3)
If the actual exercise is more than the attempted exercise then the actual exercise is reduced to match the attempted exercise. The practical implications of these equations are: when intense exercise is being performed, there may not be sufficient insulin in the blood to utilize glucose. This means that the actual energy being expended 10 is less than the exercise energy being attempted 15. When this happens the body will respond by triggering the release of more glucose 20 into the blood. This may cause the blood glucose level 21 to rise and not drop, as one would expect. To solve this problem slightly more insulin 6 should be used. Remember that during intense exercise the insulin sensitivity level increases considerably, therefore only a small amount of short acting insulin is required, typically less than one U. If too much insulin is administered before or during exercise, insulin will first be used to utilize energy (effective insulin is used) and the rest of the insulin (actual insulin) is used to store glucose. It is risky to inject too much insulin during exercise, because both insulin and exercise lower the blood glucose level therefore increasing the risk of hypoglycemia. It is also risky to start an exercise session with a low or normal blooα giucuse ιeveι even when no insulin has been administered. The diabetic should keep a carbohydrate rich snack or beverage close in case hypoglycemia does occur.
Exercise attempted and or exercise energy expended: The relationship between these two factors was discussed above in the insulin section/ The exercise attempted 15 value can be altered by using said input means to enter a value, drag the arrow to change its magnitude or by selecting exercises from the exercise database. The exercise energy expended 10 (actual exercise energy) factor cannot be changed directly by the user. This factor depends on if enough effective insulin is present. If not - then this quantity will be less than the exercise attempted and will also cause the energy from liver factor 20 to increase. Figure 7 shows a typical interface for selecting different types of exercises while figure 8 shows an interface for setting the duration of said interface. The longer the duration or the more a person'weighs or the higher the intensitiy of the exercise, the more ets energy will be expended.
Energy from liver: The main function of this factor is to counter-regulate low blood glucose levels (hypoglycemia). The user cannot directly alter this factor. When too much insulin is injected, or too much exercise energy is being expended or when there is not enough glucose in the blood the pancreas will secrete glucagon. This will trigger glycogen stored in the liver and other cells to be released as glucose for energy 20. There are various threshold values. Although for healthy persons a blood glucose level of 4mmol/l is normal, the counter regulation system will only start to make considerable efforts to increase blood glucose levels when blood glucose levels falls below 3.5 mmol/l. Here glucagon will be released. If the blood glucose level decreases further other counter regulation hormones such as cortisol and adrenalin will also be secreted to aid with the release of glucose into the blood. The counter regulation of any person has a maximum ability 19. This is related to the amount of glycogen that can be stored and also to the general condition of the counter regulation system of the specific diabetic. If a person has been a diabetic for a few years, his/her liver may have undergone some damage, which decreases its counter regulation ability 20. This maximum counter regulation value quantmeα in eis is snowπ as a line 19. This value can temporarily decrease further under the influence of alcohol, which suppresses the blood glucose counter regulation system. The value of the counter regulation factor can be calculated using the following equations: BShw-0; toBSnew> BScontrolLOW or BShw- BSconlrolHIGH -BSnew 'orBSnew
Figure imgf000010_0001
,'
Figure imgf000010_0002
Or; etSreleased = ffl released TOT θtSreleased ^>= W released] (4)
Other important parameters for the simulation model The system will comprise of an input means to enter or select several parameters needed for the simulation of the blood glucose level. Figure 1 shows the parameters that need to be set before the initiation of the simulation are: α Gender, Height, Weight, Age α Activity level (for daily energy requirement): Low, Normal, High, Weight Loser α Desired blood glucose level: Target blood glucose level α Status of diabetes: Non diabetic, Type 1 -diabetic and duration thereof α Insulin sensitivity (f,nSNorm)'- Decrease in blood glucose level per unit insulin injected. It can be measured by injecting insulin, measuring the decrease in blood glucose level and then dividing by the number of insulin units injected. „ Decrease in bloodsugαr level r . , .. . ... ,c. f,nsNorm = 7 —— — , . ■ , , [mmθl / (I.U)] (5) number of units insulin injected α ets sensitivity (featen): Increase in blood glucose level per ets ingested. It can be measured by ingesting a meal and measuring the increase in blood glucose level and then dividing the increase with the ets quantity of the meal. The ets quantity in the meal can be calculated using the following equation: . _ Increase in bloodsugar level r .. .. , .. ,_, f eaten = — f [mmol/ (l.ete)] (6) ets in meal α Exercise sensitivity (fexer)' Decrease in blood glucose level per ets unit of energy being expended. A good basal regime is required to accurately measure this factor. . Decrease in bloodsugar level . . , .. . ... ._:. f«~ = — ets energy b Te-i.ng expend ,ed , [mm°l C-u)] (7)
Figure 2 shows the possible layout of the blood glucose simulation system. The simulated blood glucose level 21 is displayed. It is dependant on the parameter values 3, 6, 9, 10, 15 and 20.
The blood glucose level is predicted as follows. The user first selects a current blood ' glucose level (BSjnιt) and desired blood glucose level (BSdesired)- The current blood glucose level is any value before a meal, exercise or insulin injection.
The diabetic user can then change the values of parameters indicated. All parameters except energy stored 9, energy released 16 and exercise energy expended 12 can be changed by merely dragging or pushing arrows up or downward or by using the input means of said system to change these values.
The blood glucose level is then calculated using the equations mentioned earlier.
The user can learn the following from this educational device: α How much insulin should be administered for a specific meal; α How much additional insulin should be administered for high blood glucose level; □ How much additional carbohydrates in necessary to raise low blood glucose levels to normal; Q How blood glucose levels will respond to exercise; α How the counter regulation system works; and α How any combination of food, exercise, insulin, high or low Diooα glucose levels should be treated. The advantages are therefore: α Less occurrences of hypo- and hyperglycemia; α Better blood glucose control; α Better comprehension of diabetes by the diabetic; α Reduced risk of diabetes complications due to poor blood glucose control.

Claims

1. An educational system demonstrating any combination of the influences of food intake, exercise, insulin and the blood glucose counter regulation system of the human body on the blood glucose level of the user with Insulin Dependant Diabetes Mellitus (IDDM) by allowing the user to dynamically change these factors and another set of parameters relating to characteristics of the human body of the said diabetic user thereby learning diabetic to improve the blood glucose control of said diabetic.
2. An education system as claimed in 1 with input means for entering or selecting dynamic (changing) values (first parameter set) for food intake; processing means for calculating the exact effect of food intake for the specific user on said user's blood glucose level.
3. An education system as claimed in 1 with input means for entering or selecting dynamic (changing) values for exercises (second parameter set) performed or exercise energy expended quantified in ets and a processing means for calculating the exact effect of food intake for the specific user on said user's blood glucose level. *
4. An education system as claimed in 1 with input means for entering or selecting dynamic (changing) values (third parameter set) for insulin dosage injected; processing means for calculating the exact effect of food intake for the specific user on said user's blood glucose level.
5. An education system as claimed in any of the preceding claims with an output means able of displaying the simulation of the blood glucose level effected by food intake, exercise and insulin injection.
6. An education system as claimed in any of the preceding claims with an output means able of displaying the simulation of the blood glucose control of a non-diabetic person by keeping the blood glucose level constant and by showing the insulin secreted by the human ooαy ana ine counter regulation mechanisms of the human body.
7. An education system as claimed in any of the preceding claims with an input means for entering or selecting a fourth set of parameters relating to characteristics of the human body namely length, weight, activity level, ets sensitivity, Insulin sensitivity and also the status of their diabetes and duration thereof.
PCT/ZA2005/000038 2004-02-19 2005-02-18 Interactive diabetes education system WO2005081119A2 (en)

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Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9233204B2 (en) 2014-01-31 2016-01-12 Aseko, Inc. Insulin management
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