Long term aim


People with Type I diabetes must give themselves insulin several times a day (by injections, or using a pump) to keep their blood glucose level (BG) in an acceptable range. The amount of insulin at each time point is based on their individual “regimen” -- essentially a formula that uses his/her current BG, as well as other factors, including the amount of carbohydrates that s/he is about to consume, and the anticipated exercise. Each regimen should be personalized -- that is, based on this person’s characteristics, and previous BG levels, etc. As people change over time, this regimen needs regular review. This review process, whether performed by the person with diabetes or the diabetes team, is facilitated by a Diabetes Diary: an electronic or paper record of that person’s glucose readings, insulin doses, carbohydrate intakes and exercise, over time. The more often the data are reviewed, and regimen updated, the more the regimen is in tune with the person’s day-to-day life. In general, theses reviews, and regimen updates, only occur during the patient’s infrequent visits to the diabetes team. We think there is a better way of doing things.

Members of the Alberta Diabetes Institute are now collaborating with the Alberta Innovates Centre for Machine Learning, with the long term goal of creating a tool that can automate this adjustment process: given relevant patient information (age, gender, weight, ...), and his/her recent Diabetes Diary, this tool will then suggest how to modify the current parameters of the formula to improve the person’s regimen. Thus our overall goal is an automated Intelligent Diabetes Manager that can suggest ways to improve the regimen (like a training diabetologist), but that is available anytime, anywhere. In the even longer term, we will explore ways to improve this process, to provide suggestions that can better anticipate how to keep the patient's BG controlled using techniques from Artificial Intelligence. Getting there will need some steps... the current step is as follows.


Short term aim

We are currently testing our IDM phone app, which is linked into the IDM website, which can serve as (1) a tool for recording and monitoring glucose levels that will make it easier to see patterns and improve glucose control, and if requested, also (2) an insulin bolus calculator.

Our app and web site can handle a wide variety of regimens for people with type 1 diabetes, including those who are taking insulin using a pump, using multiple daily insulin injections or twice or three times daily insulin regimen. The person may be using carbohydrate counting or not, a formula-based correction or insulin grid/sliding scale or any combination thereof. It is currently open (only) to people in Canada. The advantages of our system are:

The advantages of our system are:

  • Everything is recorded on that patient’s smart phone, which will sync with the IDM website, either real time or later, if you are not on-line.

  • The IDM Bolus app provides a bolus calculator linked into the web site that can be adjusted by yourself or by your diabetes care provider.

  • On the IDM web site, you or your diabetes care provider can see all your results in real time -- either the most complete diary view, or a more focused one perhaps just showing a view of the blood glucose values, all in relation to meal times (See Example) to allow you to discern glucose patterns and to easily review the effectiveness of your insulin regimen.

  • We also provide a Summary Sheet at the end of the Diary Page that displays the medians, interquartile range values and hypoglycemia frequencies for mealtimes and bedtime and for each time period (e.g. Breakfast-to-Lunch) values are grouped as normal, low or elevated allowing analysis of basal insulin, CHO ratio and correction system (See Example).