--- name: diabetes description: Diabetes management - blood glucose monitoring, HbA1c tracking, TIR analysis, hypoglycemia event logging, and complication screening argument-hint: allowed-tools: Read, Write schema: diabetes/schema.json --- # Diabetes Management Skill Comprehensive blood glucose monitoring and diabetes management to help control blood sugar and prevent complications. ## Core Flow ``` User Input -> Identify Operation Type -> Extract Parameter Info -> Check Completeness -> [Need Supplement] Ask User | [Information Complete] | Generate JSON -> Save Data -> Output Confirmation ``` ## Step 1: Parse User Input ### Operation Type Recognition | Input Keywords | Operation Type | Description | |----------------|----------------|-------------| | record, glucose, bg | glucose_record | Log blood glucose | | hba1c, a1c | hba1c_record | Log HbA1c | | trend | trend_analysis | View glucose trend | | tir | tir_analysis | View Time in Range | | hypo, hypoglycemia | hypo_event | Log hypoglycemia event | | screening, complication | complication_screening | Complication screening | | target | target_view | View glucose targets | | achievement | achievement_view | View achievement status | | medication | medication_management | Medication management | ### Glucose Type Keywords | Input Keywords | Type Value | Target Range | |----------------|------------|--------------| | fasting | fasting | 4.4-7.0 | | postprandial, 2h | postprandial_2h | <10.0 | | bedtime | bedtime | 6.0-9.0 | | random | random | - | ### Hypoglycemia Symptom Keywords | Input Keywords | Symptom | |----------------|---------| | sweating | sweating | | palpitations | palpitations | | tremor | tremor | | hunger | hunger | | confusion | confusion | | dizziness | dizziness | ### Complication Screening Types | Input Keywords | Screening Type | |----------------|----------------| | retina, 眼底, 视网膜 | retinopathy | | kidney, 肾脏, 肾 | nephropathy | | nerve, 神经, 神经病变 | neuropathy | | foot, 足, 足部 | foot_complication | ### Retinopathy Severity | Input Keywords | Severity | |----------------|----------| | none | none | | mild | mild | | moderate | moderate | | severe | severe | | proliferative | proliferative | ### Nephropathy Status | Input Keywords | Status | |----------------|--------| | normal | normal | | microalbuminuria | microalbuminuria | | macroalbuminuria | macroalbuminuria | ## Step 2: Check Information Completeness ### Glucose Record Required: - Glucose value - Glucose type (fasting/postprandial_2h/bedtime/random) ### HbA1c Record Required: - HbA1c value (%) ### Hypoglycemia Event Required: - Glucose value - Symptoms (optional) ### Complication Screening Required: - Screening type - Result status ## Step 3: Interactive Prompts (If Needed) ### Scenario A: Missing Glucose Type ``` Please select glucose measurement type: - fasting (fasting blood glucose) - postprandial (2-hour post-meal blood glucose) - bedtime (bedtime blood glucose) - random (random blood glucose) ``` ### Scenario B: Hypoglycemia Symptom Inquiry ``` Do you have any of the following symptoms? - Sweating - Palpitations - Tremor - Hunger - Confusion - Dizziness ``` ### Scenario C: Missing Complication Screening Parameters ``` Please provide detailed screening results: - Retina: none/mild/moderate/severe/proliferative - Kidney: normal/microalbuminuria/macroalbuminuria + UACR + eGFR - Nerve: normal/abnormal - Foot: normal/low_risk/high_risk + Wagner grade ``` ## Step 4: Generate JSON ### Glucose Record ```json { "id": "glu_20250620070000001", "date": "2025-06-20", "time": "07:00", "type": "fasting", "value": 6.5, "unit": "mmol/L", "in_range": true, "target_range": "4.4-7.0" } ``` ### HbA1c Record ```json { "date": "2025-06-15", "value": 6.8, "unit": "%", "target": "<7.0", "in_target": true, "change_from_previous": -0.3 } ``` ### Hypoglycemia Event ```json { "id": "hypo_20250618153000001", "date": "2025-06-18", "time": "15:30", "value": 3.4, "severity": "level_1", "symptoms": ["sweating", "palpitations"], "treatment": "glucose_tablets", "resolved": true } ``` ### Complication Screening ```json { "retinopathy": { "status": "none", "last_exam": "2025-03-20", "next_exam": "2026-03-20" }, "nephropathy": { "status": "microalbuminuria", "uacr": 45, "egfr": 78, "ckd_stage": "G2A2" }, "neuropathy": { "status": "none", "monofilament_test": "normal" }, "foot": { "status": "low_risk", "pulses_present": true, "ulcer": false, "wagner_grade": 0 } } ``` Complete schema definition: see [schema.json](schema.json). ## Step 5: Save Data 1. Read `data/diabetes-tracker.json` 2. Update corresponding sections based on operation type 3. Update statistics 4. Write back to file ## Execution Instructions ``` 1. Identify operation type (record/hba1c/trend/tir/hypo/screening/target/achievement/medication) 2. Extract parameter information 3. Check required field completeness 4. If missing, ask user to supplement 5. Generate JSON compliant with schema.json 6. Save to data/diabetes-tracker.json 7. Output confirmation and medical recommendations ``` ## Example Interactions ### Example 1: Record Fasting Glucose ``` User: record fasting 6.5 AI: Blood glucose measurement recorded Time: 2025-06-20 07:00 Type: Fasting blood glucose Value: 6.5 mmol/L Status: Within target range (4.4-7.0) Recommendation: Continue maintaining good blood glucose control ``` ### Example 2: Record Hypoglycemia Event ``` User: hypo 3.4 sweating AI: Hypoglycemia event recorded Time: 2025-06-18 15:30 Blood glucose: 3.4 mmol/L Severity: Level 1 (mild) Symptoms: Sweating, Palpitations Hypoglycemia Management Recommendations: ━━━━━━━━━━━━━━━━━━━━━━━━━━ 1. Immediately take 15g fast-acting glucose - 3-5 glucose tablets - 150ml juice or sugary drink 2. Re-check after 15 minutes 3. If still below 3.9 mmol/L, repeat step 1 4. After glucose normalizes, if >1 hour until next meal, eat small amount of long-acting carbohydrate ``` ### Example 3: Record HbA1c ``` User: hba1c 6.8 AI: HbA1c test result recorded Value: 6.8% Target: <7.0% Status: On target Change from last: -0.3% (improved) Recommendation: Test HbA1c every 3 months ``` ### Example 4: View Achievement Status ``` User: achievement AI: Blood Glucose Achievement Report ━━━━━━━━━━━━━━━━━━━━━━━━━━ HbA1c: 6.8% (target <7.0%) ✓ On target Past 7 days glucose: - Fasting: Average 6.2 mmol/L (achievement rate 85.7%) - Post-meal 2h: Average 8.5 mmol/L (achievement rate 71.4%) - Bedtime: Average 7.1 mmol/L (achievement rate 100%) TIR: 72% (target >70%) ✓ On target Hypoglycemia events: 1 (level 1) Control Evaluation: Good blood glucose control, continue ``` For more examples, see [examples.md](examples.md). ## Medical Safety Boundaries ### Cannot Do: - Provide specific medication dosage adjustment recommendations - Directly prescribe or recommend specific medications - Replace doctor's diagnosis and treatment decisions - Predict disease prognosis or complication occurrence ### Can Do: - Provide blood glucose monitoring records and trend analysis - Provide HbA1c tracking and achievement status - Provide complication screening records and reminders - Provide hypoglycemia event records and analysis - Provide lifestyle recommendations and medical visit reminders ### Emergency Medical Indications: - Severe hypoglycemia (unconsciousness, coma) - Diabetic ketoacidosis (nausea, vomiting, abdominal pain, deep breathing) - Hyperosmolar hyperglycemic state (severe dehydration, confusion) - Infection with fever and blood glucose >16.7 mmol/L