Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts.
Diabetes Technol Ther. 2019 Mar;21(3):105-109. doi: 10.1089/dia.2018.0331. Epub 2019 Jan 25.
Recent data demonstrating a lack of improvement in average hemoglobin A1c levels despite the increased use of insulin pumps and continuous glucose monitors (CGMs) suggest that patients are not using these technologies optimally. Suboptimal provider understanding of these devices may be a contributing factor.
We sought to assess fellows' knowledge, attitudes, and practices regarding insulin pumps and CGMs using a mixed-methods survey. We polled 42 pediatric endocrinology fellows and 69 attending physicians in pediatric endocrinology using items on a five-point Likert scale.
Perceived fellow knowledge of insulin pumps and CGMs was only 3.6 ± 1.0 and 3.6 ± 0.9, respectively. Despite consensus about the need for pediatric endocrinologists to understand these technologies, only 14.7% of fellows reported the presence of a formal curriculum about these technologies at their institutions. Potential gaps identified in fellows' knowledge include general use and troubleshooting, advanced insulin pump features, infusion sets and dermatological complications, systematic approach to data, interpretation and application of CGM data, and keeping pace with technological advances.
Our data suggest suboptimal fellow knowledge and understanding of insulin pumps and CGMs in pediatric type 1 diabetes management, which is likely attributable to inadequate education in fellowship training programs. The development of formal educational curricula targeting areas of weakness identified in this survey may improve clinician knowledge of these technologies and ultimately impact patient education and care.
尽管胰岛素泵和连续血糖监测器 (CGM) 的使用有所增加,但最近的数据表明,平均血红蛋白 A1c 水平并未改善,这表明患者并未最佳地使用这些技术。提供者对这些设备的理解不足可能是一个促成因素。
我们使用混合方法调查评估研究员对胰岛素泵和 CGM 的知识、态度和实践。我们使用五点李克特量表对 42 名儿科内分泌学研究员和 69 名儿科内分泌学主治医生进行了调查。
感知到的研究员对胰岛素泵和 CGM 的知识分别仅为 3.6±1.0 和 3.6±0.9。尽管一致认为儿科内分泌学家需要了解这些技术,但只有 14.7%的研究员报告说他们所在机构有关于这些技术的正式课程。研究员知识中的潜在差距包括一般用途和故障排除、先进的胰岛素泵功能、输注套件和皮肤并发症、数据的系统方法、CGM 数据的解释和应用,以及跟上技术进步的步伐。
我们的数据表明,在儿科 1 型糖尿病管理中,研究员对胰岛素泵和 CGM 的知识和理解不足,这可能归因于在研究金培训计划中教育不足。针对本调查中确定的薄弱领域制定正式的教育课程可能会提高临床医生对这些技术的了解,并最终影响患者的教育和护理。