Endocrine Abstracts

Introduction and objectives: In clinical practice many professionals are involved in the diabetes treatment. To facilitate this work, we present a computer program, based in recommended guidelines, to improve the management of insulin therapy, called insulinator. We evaluated the correlation between these and clinical practice.

Materials and methods: Insulinator has been made so that using a number of variables (weight, HbA1c and glycemic control) offer an orientation on the insulin therapy dose. This program present several regimens (basal insulin, mixtures, and basal-bolus regimen). You can start insulin, adjust the same regimen and increase to superior regimen. From 250 clinical histories, we compared the regimen and total dose introduced by endocrinologists in clinical practice, with virtually provide this software tool. The main variable is the concordance between both, considered as such an approximation of ±15% of the total dose of insulin.

Results: Adjustment of the same regimen: C (concordance) L (lower dose) H (higher dose).

1 Basal insulin (29): C 93.10%, L 3.45%, H 3.45%.

2 Basal-bolus therapy (43): C 90.70%, L 4.65%, H 4.65%.

Intensification to a superior regimen.

C (concordance) L (lower dose) H (higher dose).

1 Start basal insulin (36): C 52.78%, L 33.33%,H 13.18%.

2 Start Basal-Bolus regimen (60): C 33.33%, L 48.33%, H 18.33%.

3 Basal insulin to basal-bolus regimen (20): C 80.00%, L 5.00%, H 15.00%.

4 Mixtures to basal-Bolus regimen (62): C 79.03%, L 9.84%, H 11.29%.

Conclusions: Insulinator is a useful tool in insulin manegement, showing concordance with useful clinical practice. We appreciate that the adjustment presents a very high concordance. However in the intensification this concordance is less, because it tends to underestimate the final dose of insulin. This has been intentionally in this direction to reach the same point but more prudently. Finally will be the professional who, based on calculations recommended by the program and considering the individual patient factors choose the final dose and insulin regimen.