Insulin dosage adjustment in diabetes.

A prototype computer system has been developed to provide advice on the day-to-day adjustment of carbohydrate intake and insulin regimen in the insulin-treated diabetic patient. The system also produces a 24-hour simulation of the patient's blood glucose profile based on these adjustments. Advice is generated by a qualitative knowledge-based system which suggests what the next step in improving glycaemic control might be for a given patient, e.g. 'decrease evening medium-acting insulin by two units'. Simulations are provided by a non-linear model which consists of a one-compartment glucose model linked to a model with plasma and 'active' insulin compartments. A description of the integrated system is provided and its operation illustrated by clinical case studies from insulin-treated diabetic patients.