We propose to develop a portable computer based compliance-enhancement and decision making system (Diacare Program) for use in the treatment of insulin dependent diabetes. The Diacare Program will be designed to operate on a hand held computer which can be carried around by the patient. It will automatically prompt the patient to eat prescribed meals, administer the appropriate insulin dosage and enter required data. Insulin dosages will be adjusted periodically according to a standard algorithm. In addition to the hand held computer, the Diacare Program will also include a microcomputer based physician base station. This system will allow the physician to download data from the hand held computer as well as change prescriptions for diet and insulin. With the addition of a MODEM system this communication will be possible remotely. In Phase I of this project we plan to complete development of the system and demonstrate its usability and """"""""user friendliness"""""""". A Phase II application is planned in which the project will be tested on a group of forty patients who have opted to learn home glucose monitoring and have enrolled in the Diabetes Training Program at the University of Virginia Medical Center. The development of the Diacare Program will constitute a major advance in diabetes care and in the implementation of expert systems. While present expert systems technology focuses at aiding the professional in making decisions, the Diacare Program will assist the patient in self-care. Furthermore, because of its remote capabilities it will allow high level medical supervision where personal physician contact is not possible. By improving patients' ability to control blood sugar, the Diacare Program should help in the prevention of complications related to chronic hyperglycemia.
