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A predictive tool for the self-management of diabetes (Librae): evaluation using a continuous glucose monitoring system.
Diabet Med. 2006 Jan; 23(1):21-5.DM

Abstract

AIMS

Diabetes self-management involves a difficult balancing act between insulin, food and exercise. The challenge is to develop innovative, validated algorithms to aid patient decision-making and optimize glycaemic control. 'Librae' is a computerized diabetes simulator in diary format, developed as an educational predictive tool for patients, reducing 'trial and error' by allowing patients to simulate and experiment with dietary or insulin adjustments on a 'body double'. We have evaluated the predictive ability of Librae using continuous blood glucose monitoring (CGMS).

METHODS

Patients with Type 1 Diabetes attending the Paediatric Clinic were invited to use 'Librae' for 1 week and were then fitted with a CGMS for 72 h. The predictive ability of 'Librae' was compared with concurrent data obtained from the CGMS.

RESULTS

Seven thousand nine hundred and sixty paired blood glucose values were obtained from the 11 patients who completed the study. 'Librae' underestimated the measured CGMS values, the error having a positive mean of 0.35 mmol/l (95% confidence interval 0.22-0.48 mmol/l). However, Librae tended to overestimate at low levels of blood glucose readings, and underestimate at high levels of blood glucose readings.

CONCLUSION

The modelled values of 'Librae' correlated well with the CGMS data, but clinically unacceptable errors occurred at extremes of blood glucose levels. Concurrent CGMS recordings have provided a large data set to modify and improve the existing Librae model and patient feedback has led to improvements in its usability. Librae may provide a useful tool to improve diabetes self-management education and optimize glycaemic control.

Authors+Show Affiliations

Maternal and Child Health Sciences, Ninewells Hospital and Medical School, Dundee, UK. v.franklin@dundee.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16409561

Citation

Franklin, V L., et al. "A Predictive Tool for the Self-management of Diabetes (Librae): Evaluation Using a Continuous Glucose Monitoring System." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 23, no. 1, 2006, pp. 21-5.
Franklin VL, Wilson AW, Butler RA, et al. A predictive tool for the self-management of diabetes (Librae): evaluation using a continuous glucose monitoring system. Diabet Med. 2006;23(1):21-5.
Franklin, V. L., Wilson, A. W., Butler, R. A., & Greene, S. A. (2006). A predictive tool for the self-management of diabetes (Librae): evaluation using a continuous glucose monitoring system. Diabetic Medicine : a Journal of the British Diabetic Association, 23(1), 21-5.
Franklin VL, et al. A Predictive Tool for the Self-management of Diabetes (Librae): Evaluation Using a Continuous Glucose Monitoring System. Diabet Med. 2006;23(1):21-5. PubMed PMID: 16409561.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A predictive tool for the self-management of diabetes (Librae): evaluation using a continuous glucose monitoring system. AU - Franklin,V L, AU - Wilson,A W, AU - Butler,R A, AU - Greene,S A, PY - 2006/1/18/pubmed PY - 2006/5/9/medline PY - 2006/1/18/entrez SP - 21 EP - 5 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 23 IS - 1 N2 - AIMS: Diabetes self-management involves a difficult balancing act between insulin, food and exercise. The challenge is to develop innovative, validated algorithms to aid patient decision-making and optimize glycaemic control. 'Librae' is a computerized diabetes simulator in diary format, developed as an educational predictive tool for patients, reducing 'trial and error' by allowing patients to simulate and experiment with dietary or insulin adjustments on a 'body double'. We have evaluated the predictive ability of Librae using continuous blood glucose monitoring (CGMS). METHODS: Patients with Type 1 Diabetes attending the Paediatric Clinic were invited to use 'Librae' for 1 week and were then fitted with a CGMS for 72 h. The predictive ability of 'Librae' was compared with concurrent data obtained from the CGMS. RESULTS: Seven thousand nine hundred and sixty paired blood glucose values were obtained from the 11 patients who completed the study. 'Librae' underestimated the measured CGMS values, the error having a positive mean of 0.35 mmol/l (95% confidence interval 0.22-0.48 mmol/l). However, Librae tended to overestimate at low levels of blood glucose readings, and underestimate at high levels of blood glucose readings. CONCLUSION: The modelled values of 'Librae' correlated well with the CGMS data, but clinically unacceptable errors occurred at extremes of blood glucose levels. Concurrent CGMS recordings have provided a large data set to modify and improve the existing Librae model and patient feedback has led to improvements in its usability. Librae may provide a useful tool to improve diabetes self-management education and optimize glycaemic control. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/16409561/A_predictive_tool_for_the_self_management_of_diabetes__Librae_:_evaluation_using_a_continuous_glucose_monitoring_system_ L2 - https://doi.org/10.1111/j.1464-5491.2005.01770.x DB - PRIME DP - Unbound Medicine ER -