Educational software for understanding integrated blood glucose effects

Abstract

The World Health Organisation considers diabetes mellitus as a fast-growing epidemic. The number of documented cases increase each year; together with the number of patients hospitalised due to complications associated with the disease. These long- and short-term complications can include blindness, kidney failure, circulatory diseases, neuropathy, to name a few. The management of diabetes is a lifelong procedure that can become very expensive. Often patients lapse in their efforts. The education of diabetics, family members and care providers is therefore essential to ensure that lifelong accurate, continuous blood glucose control is achieved. This can decrease the occurrence or severity of complications. Simulation models describing the human blood glucose system became more popular as the twenty-first century approached and computers became part of everyday life. These models are often used to educate diabetics rather than using conventional educating methods. Several such models exist, however, none offers an integrated approach to incorporate all the external and internal influences on the blood glucose system. These models were developed to simulate blood glucose response to several of these influences, but not in an integrated manner. To fill this gap, an integrated simulation model was developed that incorporates the equivalent teaspoons sugar (?) concept. ? is a newly developed generic energy unit used to determine the energy value of food, beverages, exercise, stress as well as the regulation and counterregulation hormones. This simplifies the mathematical model of the blood glucose system and is also easy for diabetics to implement in their everyday lives. This led to the development of the educational simulation model, Edutool diabetes simulator, that incorporates the ? concept. The Edutool is an educational program for people with diabetes, non-diabetic people, care providers and medical professionals. The mathematical model behind the simulator has been experimentally validated. Due to the many simulation models that currently exist, it is essential to validate the model to determine its userfriendliness and educational value. This experimental validation and evaluation of the Edutool was questionnaire-based and the results statistically analysed. The validation of the questionnaire was done by three experts in the field of diabetes and endocrinology. Three questionnaires were developed to evaluate the educational value of the Edutool, assess its ease-of-use and compare it to another educational diabetes simulator (AIDA). A quick-start guide presentation was also developed to assist the user in understanding the basic diabetes and blood glucose concepts as well as show the user how the Edutool works. This presentation was developed so that a primary school child would understand the concepts being explained. The next step was to set up the trials. The trials took place at Curro Hazeldean Primary and Curro College Hazeldean, both situated in Pretoria. A trial protocol was set up to explain the exact order of events in the trial. Information release forms were also required for all minors participating in the trials. These were signed by parents or guardians of the participants and returned prior to the start of the trial. In the primary school trial, the increase in total test results was 40% after watching the quick-start guide presentation and working on the Edutool. After working on the AIDA simulator, all participants preferred the Edutool. The secondary school trial was also very successful. The results showed a 35% increase in the total test score. In this group all the participants also preferred the Edutool to the AIDA program. For both trials the p-value was smaller than 0.001, which indicates that the increase in total test scores for the trials are statistically significant. From these results it can be concluded that the Edutool, together with the quick-start guide presentation, has improved the knowledge of the participants in both trials significantly. This validates the educational value of the Edutool. The ease-of-use of the program was also validated by the results of the open-ended questions, and therefore the Edutool can be regarded as a validated educational software program.