Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH, 43210, USA.
Curr Diab Rep. 2019 Nov 4;19(11):110. doi: 10.1007/s11892-019-1232-4.
Coordination of glucose monitoring, mealtimes, and insulin delivery in the hospital is complex, involving interactions between multiple key agents and overlapping workflows. The purpose of this review is to evaluate the scope of the problem as well as to assess evidence for interventions.
In recent years, there has been an emphasis on systems-based approaches which address multiple contributing components of the problem at once in an effort to more seamlessly integrate workflows. Technological advances, such as decision support systems and advances in automated insulin delivery, and strategies that minimize the need for complex insulin regimens hold promise for future study. Evaluation of the coordination of insulin delivery is limited by a lack of standardized metrics and systematically collected mealtimes. Nevertheless, successful efforts include system-wide multicomponent interventions, though advances in therapeutic approaches may be of value.
在医院中协调血糖监测、进餐时间和胰岛素输注较为复杂，涉及多个关键因素之间的相互作用以及重叠的工作流程。本文的目的是评估该问题的范围，并评估干预措施的证据。
近年来，人们越来越重视系统方法，该方法可以同时解决问题的多个相关组成部分，努力更无缝地整合工作流程。技术进步，如决策支持系统和自动胰岛素输送的进步，以及尽量减少复杂胰岛素方案需求的策略，为未来的研究带来了希望。由于缺乏标准化指标和系统收集的进餐时间，胰岛素输送的协调性评估受到限制。尽管如此，成功的努力包括系统范围的多组分干预措施，尽管治疗方法的进步可能具有价值。
