Ryff-de Lèche A, Engler H, Nützi E, Berger M, Berger W
Department of Diabetology and Endocrinology, University Hospital, Basel, Switzerland.
Diabetes Res. 1992 Mar;19(3):97-105.
In two consecutive studies the clinical application and suitability of two computer-assisted data management systems (Camit and Cadmo) were evaluated in a prospective manner. In each study nineteen long-standing, stable insulin-dependent patients were randomly assigned to one of two groups. In study I assessment of metabolic control and insulin dose adjustments were based either on the Camit S1 data analysis or on the conventional log-book method, whereas in study II the Camit S2 and the Cadmo simulation programs were evaluated. HbA1c values decreased significantly in both studies (p < 0.05). A clear decline in hypoglycemic events as well as a significant reduction of the percentage of glucose values below 4.0 mmol/l (p < 0.005) and a marked increase (p < 0.05) in the percentage of glucose levels in the target range (4.0-10.0 mmol/l) were observed. We found both computerized assessment systems to be reliable and suitable for the assessment of blood glucose control and for insulin dose finding. The graphical and statistical presentation of the numerous glucose and insulin data allowed a better summary of blood glucose control and metabolic trends. More time could be spent for problem solving, which proved to be much less exhausting with the computer for the attending physician. Further studies should address the educational potential of computerized systems for the patient as well as for the physician.
在两项连续的研究中，以前瞻性方式评估了两种计算机辅助数据管理系统（Camit和Cadmo）的临床应用及适用性。在每项研究中，19名长期稳定的胰岛素依赖型患者被随机分为两组。在研究I中，代谢控制评估和胰岛素剂量调整要么基于Camit S1数据分析，要么基于传统的日志记录方法，而在研究II中，对Camit S2和Cadmo模拟程序进行了评估。两项研究中糖化血红蛋白（HbA1c）值均显著下降（p<0.05）。观察到低血糖事件明显减少，血糖值低于4.0 mmol/l的百分比显著降低（p<0.005），而目标范围内（4.0 - 10.0 mmol/l）血糖水平的百分比显著增加（p<0.05）。我们发现这两种计算机化评估系统对于评估血糖控制和确定胰岛素剂量都是可靠且适用的。大量血糖和胰岛素数据的图形化及统计呈现能更好地总结血糖控制和代谢趋势。可以花更多时间解决问题，事实证明，对主治医生来说，使用计算机解决问题要轻松得多。进一步的研究应探讨计算机化系统对患者和医生的教育潜力。
