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Published review #1:
Reproduced with permission from from Diabetes/Metabolism Research and Reviews - July 1999 issue, Volume 15 - copyright 1999 John Wiley & Sons Ltd.

The Virtual Diabetic Patient: AIDA on-line
AIDA on-line contains a simple interactive model of the human glucoregulatory system. It allows you to simulate the effect on the blood glucose profile of changes in insulin and diet for a typical insulin-dependent (Type 1) diabetic patient. Given the complexity of the human glucoregulatory system it is not possible for a simple model, such as that contained within AIDA on-line, to accurately predict an individual patient's blood glucose profile.
For this reason AIDA on-line is provided solely as an educational 'toy' to allow interested patients, their relatives, students and health-care workers to experiment with insulin dosage and dietary adjustments on their own personal computer. It is not intended to be used as a basis for treating individual patients
Forty sample case scenarios are provided and you can also add/simulate further cases. The stated purpose of the site is to try to enhance understanding of the processes involved in achieving good glycemic control - by demonstrating how insulin and diet can affect blood glucose levels.
One of the relative strengths of the on-line simulation approach is that it is highly interactive - allowing you to change any of the input variables (insulin dosage, timing, or preparation), or nutritional information (meal size or timing), plus other clinical variables (renal function, weight, insulin sensitivity) and see the resulting effects on the blood glucose profile - within seconds. In this respect the site is quite unique. All interactions take place via a standard web browser window, so no special downloads or installation are required. I know of no similar website offering this sort of facility anywhere on the Internet.
To give some examples of what the website can do - you could simulate what would happen to a hypothetical patient's blood glucose profile if the carbohydrate content of breakfast was increased, or if the supper time short-acting insulin dose was decreased, or an injection time moved earlier, or a meal time shifted later. You could replace a split-evening dose insulin regimen with two combined injections per day, or transfer a patient to a pre-mixed (bi-phasic) insulin preparation in place of short- and intermediate-acting preparations, or perhaps try introducing a 'pen regimen' taking a long-acting insulin preparation at night with a short-acting preparation three times daily before each main meal. The list of possibilities is endless.
There is also a PC (but not Macintosh, unless you have SoftWindows) version of the AIDA diabetes simulator. This has been made available as *freeware* on the web and can be downloaded from the Diabetes UK web site [Archive update: this is now available here from this site (].
This PC software has also been made available free-of-charge to the British Diabetic Association (BDA) and they have chosen, in turn, to make it available on diskette with a printed bound manual, to health-care professionals, through one of their product catalogues.
The 'AIDA on-line diabetes simulator' provides a useful facility on the web. It also demonstrates how it is possible to move from purely static/informational web-based resources to using the Internet to provide more interactive and dynamic simulations of clinically relevant situations.

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Published review #2:
Reproduced with permission from DFAN/OneStep Diabetes Newsletter - March 1999 Edition

Would you like to see how insulin affects blood glucose without having to inject it? How about "seeing" glucose lows on a screen instead of experiencing them yourself? AIDA On-Line and it's companion program AIDA v4.0 is exactly what's needed to do both of these tasks.
AIDA On-Line is a site every diabetic should visit at least once, if not more. The AIDA information describes it as a "simple model of glucose-insulin interaction" but the understanding this program might bring to diabetics and their families and friends is far more reaching.
"This program is a wonderful VISUAL component in letting a newly diagnosed insulin user 'see' what is happening and how it is happening, and how the insulin HELPS their condition become treatable and livable," says one AIDA user. "Diabetes doesn't have to be thought of as a death sentence. With the right information, and the correct way of presenting it, anyone can understand it."
When it comes to diabetes, visual models can explain aspects of the disease that words might leave confusing. The illustrations used are simple and very easy to understand. Another user shares, "It does help a diabetic understand more clearly the relationship between carbohydrate uptake and insulin. It would be very useful in teaching new diabetics how to control their blood glucose levels.
So take a few minutes, visit the AIDA On-Line site, and download their program. It's well worth the time, and you may just understand diabetes a little better.

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A doctor writes

I am a resident physician in family practice. The patient population at our clinic is comprised of a mixture of ethnic origins including native American Indian, Latin American, African, European, Asian and others. Because we see a lot of diabetes and insulin resistance, I find myself, sometimes with a sense of futility, attempting to explain to patients the serious nature of their disease and the potential consequences of poor compliance. Yet noncompliance remains purvasive. I intend to use your program both for student demonstrations and for patient education. Thank you for your considerable efforts in creating and publishing this valuable program.

Dr. T.J. Jones
Kansas City, Missouri, U.S.A.

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A nurse writes:

Insulin dependent diabetes is a very complex disease which requires vigilant monitoring by diabetic patients to ensure their person's homeostasis. For diabetic patient's, there is a distinct interplay between insulin, meals, and the resulting glucose profiles. All of these individual factors need to be taken into account to help diabetic patients understand their interdependence. The comprehension of the interdependence between these variables will assist diabetic patients to improve their insulin therapy and will promote improved control of diabetic patients' blood glucose profiles. AIDA utilizes differential mathematical equations to develop simulations that appear graphically to the patient after the patient enters in unique values for body weight, insulin type and dosage, insulin sensitivity, and carbohydrates consumed. AIDA allows patients to view the distinct interplay between insulin, meals, and the resulting glucose profiles through a simulation. AIDA has achieved an accurate simulation by taking into account the many physiological events of the metabolism of an insulin dependent diabetic patient. AIDA has modeled the pharmokinetics of subcutaneous injections of insulin by utilizing differential equations. As stated in AIDA, the plasma insulin profiles are not individualized for any particular patient and represents a typical response to the pharmokinetics of insulin. A major stride AIDA has acheived is the utilization of inter-individual differences in insulin sensitivity. AIDA allows for patients to enter in these individualized sensitivites, which promotes a more customized simulation. .... AIDA is a tremendous supplemental aid for diabetic education and motivation by promoting the understanding of the interdependence betweeen diabetic patient's insulin, meals, and resulting glucose profiles.

Philip Wilcox, RN, PHN, MSNc
San Francisco, California, U.S.A.

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Some patients write:

I think the program is very useful. Shortly after I was diagnosed I downloaded an earlier (PC) version from Compuserve and ran more than a hundred simulations trying to get a feeling for cause and effect and found this very useful. I tried to get some people of the Dutch Diabetes Society (DVN) interested in using it for training purposes but ran into problems of a logistical nature; no laptops, no lcd screens etc, etc. Possibly it is a bit much for the average computer illiterate diabetic but it should be very helpful for a lot of people.

It helps me to let my fiance see how insulin works and affects me. It makes it easier for him to understand. I think this is a great learning tool!

While this is merely an informational tool, because of the number of variables that are individualized, I find it useful to suggest changes in regimens that may be further discussed with one's endocrinologist. It does help a diabetic understand more clearly the relationship between carbohydrate uptake and insulin. It would be very useful in teaching new diabetics how to control their BG's.

The program provides very useful information. Being able to iteratively change the insulin and meal regimes, and observe the probable effect on glucose levels is very enlightening.

It is interesting to enter one's current regime and see how the glucose profile compares to the actual readings. Finding possible explanations for the difference can give some interesting insights into one's own condition.

I think this program can be very benefical for both patients and doctors for learning about managing diabetes.

Can you outline briefly how you might see AIDA on-line being used?

When a person with diabetes is first beginning to 'fine tune' insulin use to achieve tight control. Also perhaps in the training given to diabetes educators as visual learning. Then, also as people's requirements change - activity levels, weight changes etc. It is a possible predictor of possible results.

Can you outline briefly how you might see AIDA on-line being used?

I have been using it as a "dummy patient" for an insulin regime. I suppose it can also be used to educate new diabetics. It's kinda cool to get an idea of what your body would do if..., to simulate that a big piece of mudcake is not the best choice of snack.

Can you outline briefly how you might see AIDA on-line being used?

For both physicians and med students, to familiarize them with the interactions that occur when changes are made in diet or insulin. Neat tool.

Can you outline briefly how you might see AIDA on-line being used?

In Dr's offices, easily accessible to them and FREE, they might check their dosage instructions against a recognized standard and show their patients what any changes might mean to them. The result might mean greater patient adherence to instructions, a more involved meeting at the Dr's office in less or the same amount of time, better Dr / Patient relationship and the resulting successful professional practice. In the home the patient might deepen her understanding of this potentially dangerous hormone's action on the body and maintain a level of interest in the Dr's advice sufficient to successfully manage this chronic disease. The program should be expanded to be useful to insulin pump users as well as those who inject insulin and to be useable with information downloaded from medical devices such as blood glucose meters and insulin pumps. Since insulin was first used to treat diabetes, the biggest advances in diabetes treatment has come in the form of technology-not new drugs or therapies. Multi-injections did not become accepted until after the availability of glucose monitors. The weak link between glucose testing and multiple injection therapy can be made strong by the use of your program.

Can you outline briefly how you might see AIDA on-line being used?

I plan to have my Family Nurse Practitioner students work through the exercises, I think this is an excellent tool for them to understand all of the complexities of prescribing diabetes therapies - Dr. Sharon Johnson, San Francisco State University, U.S.A.

Can you outline briefly how you might see AIDA on-line being used?

I think your software tool is the most advanced one available. Your software should help me experiment to have better control of my diabetes. I used at least three programs linked to gloucose meters before, but you just get a lot of statistical data that does not guide a lot. The simulation tool that you have created is a most powerful tool.

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AIDA Website home Return to AIDA Website Home Page AIDA is a freeware diabetes software simulator program of glucose-insulin action + insulin dose & diet adjustment in diabetes mellitus. It is intended purely for education, self-learning and / or teaching use. It is not meant for individual blood glucose prediction or therapy planning. Caveats

This Web page was last updated on 9th December, 2000. (c), 2000. All rights reserved. Disclaimer. For the AIDA US Mirror Site, please click here. For the Diabetes / Insulin Tutorial, please click here.