Glucose prediction, iatrogenic hypoglycemia and medical intervention: the role of the Diabetes Data Centre

Background: Glycemic control is fundamental to the management of diabetes and maintenance of health. Popular measures of performance in glycemic control include A1c and self-monitoring of blood glucose (SMBG). As measures of performance, A1c has perspective but fails to recognize hypoglycemia while SMBG lacks overall perspective but finds use mainly by patients to self evaluate their glycemic status and current response to therapy. Predictions of future glycemia and the risks of hypoglycemia are now available to assist providers with interventions that avert iatrogenic hypoglycemia.Methods and results: A diabetes data centre has been created. It incorporates the customary hardware and, besides the usual database services, provides an engine for glycemic prediction that can utilize SMBG data captured remotely. Clinical use of the engine's glucose predictions support interventions that avert iatrogenic hypoglycemia while allowing providers to optimize glycemic control. Other centre resources include distribution of supporting software and user instruction.Conclusions: Use of the resources of a shared diabetes data centre can empower providers to identify problems in glycemic control, take proactive action, adopt beneficial strategies, evaluate outcomes and, most importantly, avoid interventions that engender hypoglycemia. In this light, glycemic predictions appear crucial to better diabetes care.