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Updated: Mar 21, 2026
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Clinical Safety and Feasibility of the Advanced Bolus Calculator for Type 1 Diabetes Based on Case-Based Reasoning: A
Monika Reddy1, Peter Pesl2, Maria Xenou1
11 Division of Diabetes, Endocrinology and Metabolism, Imperial College London , London, United Kingdom .
Background:
The Advanced Bolus Calculator for Diabetes (ABC4D) is an insulin bolus dose decision support system based on case-based reasoning (CBR). The system is implemented in a smartphone application to provide personalized and adaptive insulin bolus advice for people with type 1 diabetes. We aimed to assess proof of concept, safety, and feasibility of ABC4D in a free-living environment over 6 weeks.
Methods:
Prospective nonrandomized single-arm pilot study. Participants used the ABC4D smartphone application for 6 weeks in their home environment, attending the clinical research facility weekly for data upload, revision, and adaptation of the CBR case base. The primary outcome was postprandial hypoglycemia.
Results:
Ten adults with type 1 diabetes, on multiple daily injections of insulin, mean (standard deviation) age 47 (17), diabetes duration 25 (16), and HbA1c 68 (16) mmol/mol (8.4 (1.5) %) participated. A total of 182 and 150 meals, in week 1 and week 6, respectively, were included in the analysis of postprandial outcomes. The median (interquartile range) number of postprandial hypoglycemia episodes within 6-h after the meal was 4.5 (2.0-8.2) in week 1 versus 2.0 (0.5-6.5) in week 6 (P = 0.1). No episodes of severe hypoglycemia occurred during the study.
Conclusion:
The ABC4D is safe for use as a decision support tool for insulin bolus dosing in self-management of type 1 diabetes. A trend suggesting a reduction in postprandial hypoglycemia was observed in the final week compared with week 1.
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