Efficacy of automatic bolus calculator with automatic speech recognition in patients with type 1 diabetes: A randomized cross-over trial
具有自动语音识别功能的自动剂量计算器在1型糖尿病患者中的应用:一项随机交叉试验
Abstract
enBackground
Patients using an insulin pump as part of their diabetes treatment need to calculate insulin bolus doses to compensate for a meal. Some patients do not modify their meal boluses according to changes in the amount and composition of food products in a meal. The lack of correct meal boluses leads to unstable, and therefore harmful, blood glucose levels. The aim of the present study was to test a system supporting bolus determination based on a voice description of a meal.
Methods
The bolus calculator developed (VoiceDiab) consists of a smartphone application and three remote servers for automatic speech recognition, text analysis, and insulin dosage calculation. Forty-four people with type 1 diabetes (T1D) treated with continuous subcutaneous insulin infusion finished the randomized cross-over study. Patients were randomly allocated to the group in which the VoiceDiab system supported bolus calculation or to an unsupported group, in which patients or their caregivers calculated boluses. After a 14-day washout period, patients from the supported group were switched to the unsupported group, whereas those in the unsupported group were switched to the supported group.
Results
There was a significant difference between the supported and unsupported groups in the percentage of patients with 2-h postprandial glycemia within the 70–180 mg/dL range (58.6% vs 46.6%, respectively; P = 0.031).
Conclusions
The VoiceDiab system improves postprandial glucose control without increasing the time in hyperglycemia or hypoglycemia. Therefore, it may be useful in the treatment of patients with diabetes on intensive insulin therapy.
摘要
zh当患者的糖尿病治疗方案中需要用到胰岛素泵时, 需要计算胰岛素追加剂量以降低进餐导致的血糖升高。而有些患者不会根据膳食中的食物数量与组成变化来调节他们的餐前胰岛素追加剂量。餐前追加剂量调节不正确会导致血糖水平不稳定且对患者不利。本研究的目的是测试一个根据对膳食的语音描述识别来决定确定追加剂量的系统。
方法
追加剂量计算器(VoiceDiab)包括智能手机应用程序以及3个用于自动语音识别、文本分析以及计算胰岛素剂量的远程服务器。有44名使用持续皮下胰岛素输注治疗的1型糖尿病患者完成了这项随机交叉研究。患者被随机分配到VoiceDiab系统支持计算追加剂量的分组或者不支持的分组, 后者由患者或者他们的护理人员来计算追加剂量。经过14天的洗脱期之后, 将支持组患者转换为不支持组患者, 反之将不支持组患者转换为支持组患者。
结果
在支持组与不支持组患者之间, 餐后血糖处于70-180 mg/dL范围内的比例存在显著性差异(分别为58.6%与46.6%;P = 0.031)。
结论
VoiceDiab系统可以改善餐后血糖控制, 并且不会增加高血糖或者低血糖的持续时间。因此, 它有助于糖尿病患者进行胰岛素强化治疗。
