Telematic expert system Diabeto: New Tool for Diet Self-Monitoring for Diabetic Patients

Abstract

Objective — To evaluate Diabeto, a computer-assisted diet education system. Research Design And Methods — One hundred five patients with insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) were divided into two randomized groups to participate in the evaluation of Diabeto. With free access through Minitel, the French public videotex network, Diabeto helps diabetic patients self-monitor their diets and balance their meals with personalized counseling. Results — During the first 6-mo study, group A (54 patients) used Diabeto, whereas group B (51 patients) were control subjects. For the second 6-mo study, group B used the system. Evaluation was based on patients' dietetic knowledge, dietary habits, and metabolic balance. Conclusions –Diabeto led to a significant improvement of dietetic, knowledge in group A (P < 0.0005) and also to improved dietary habits; decreased caloric intake in patients initially overeating (P < 0.05), increase of dietary carbohydrate from 39.7 ± 0.7 to 42.9 ± 0.9% in patients with an initial intake <45% carbohydrate, and decrease of fat intake from 41.9 ± 0.9 to 37.4 ± 1.1% in patients with an initial intake of >35% fat (P < 0.0005). In the second study, in addition to similar improvements to those observed in the first study, HbA1 decreased from 11.0 ± 0.4 to 9.9 ± 0.4% (P < 0.005) and fructosamine from 5.00 ± 0.17 to 4.57 ± 0.17% (P < 0.001). Diabeto appears to be an effective therapeutic tool in the control of metabolic diseases.