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AIDA On-line

By David Mendosa

Last Update: May 1, 1999

The man is a newly diagnosed type 1 diabetes patient. When he took either two or three insulin injections daily, he had problems maintaining good blood glucose control. So he now takes four injections per day. But he still tends have to quite high blood glucose levels in the middle of the day, despite not eating excessively.

See if you can reduce his BGLs.

This is one of 40 case studies that you can interact with in AIDA On-line. Your task, if you chose to accept it, is to try to see if you can reduce his mid-day blood glucose levels.

With this program you can change any of the input variables—insulin dosage, timing, or types of insulin. Or you can change how many carbohydrate grams and when he eats up to six meals a day. When you enter your changes, you can see immediately what effect they have on his blood glucose profile and plasma insulin level.

Being able to see the impact of these changes so quickly makes AIDA a valuable teaching tool. It is a simulator—a way for interested patients, their relatives, students, and health-care workers to experiment with insulin dosage and dietary adjustments necessary to control diabetes.

AIDA On-line is based on a simple model of how the body of a typical type 1 diabetes patient regulates glucose. The model assumes that the patient's pancreas produces no insulin.

The program's educated guess about what might happen to a diabetic patient following a change in either insulin or diet is based on a large number of assumptions. But it is a way to gain an increased knowledge and a deeper understanding of the interplay between the processes involved.

The model still does not include everything. It leaves out the effects of exercise and stress. Nor does it recognize that not all carbohydrates are created equal in their blood glucose effects.

Given those limitations, AIDA On-line can teach a lot about the often subtle interactions of diet and insulin doses. Each of the 40 case studies has a different set of variables and each represents a different set of control problems.

You can even start the program with a clean slate and enter your own types of insulin, dosages, times of injection, carbohydrate consumption, and meal times. You can save that profile and then update it with the changes that you are thinking of making in your real life.

Just don't treat the program as a tool for therapy. That's a theme the authors of the program repeatedly emphasize. Remember the acronym YMMV. Your mileage may vary because you are an individual and everybody's diabetes is a little different.

Dr. Eldon Lehmann of the Imperial College of Science, Technology and Medicine and of Royal Brompton Hospital in London, England, and his associates developed the original AIDA program and released it in 1996. Version 4 of the original program remains available at AIDA.

It is, however, an MS-DOS program that runs only on PCs. By contrast, AIDA On-line uses the functionality of the Web to bring this unique teaching tool to all types of computers. By presenting 40 cases of virtual diabetes the program helps to give a much better understanding of how to control diabetes in real life. 

The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.

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