Center for Diabetes and Endocrinology, University of Maryland Midtown Campus, Baltimore, MD, USA.
Individual Contributor, Hagerstown, MD, USA.
J Diabetes Sci Technol. 2020 Sep;14(5):917-921. doi: 10.1177/1932296820906204. Epub 2020 Mar 5.
Type 1 diabetes is a unique disorder, requiring constant and vigilant assessment of glucose levels, food/snacks consumed, activities and exercise, emotions and stress, hormonal influence, and illness. No other diagnosis is as intensive in terms of the "burden" of care that impacts the patient/family physiologically, cognitively, and psychologically. Several Do-It-Yourself (DIY) closed-loop systems currently exist and can provide options for patients and families looking to reduce the burden of type 1 diabetes. However, as the systems are not Food and Drug Administration approved, healthcare providers are faced with the decision of whether to support patients using DIY systems. This manuscript discusses the ethics of choice and patient autonomy from the perspective of patient/family and healthcare provider. A set of proposed guidelines for healthcare providers are also presented for consideration when interacting with a patient or family who desires to use a DIY system to help manage type 1 diabetes.
1 型糖尿病是一种独特的疾病，需要持续、警惕地评估血糖水平、所摄入的食物/零食、活动和运动、情绪和压力、激素影响以及疾病。没有其他诊断像 1 型糖尿病那样，在影响患者/家庭生理、认知和心理的“负担”方面如此密集。目前有几种 DIY 闭环系统，可以为寻求减轻 1 型糖尿病负担的患者和家庭提供选择。然而，由于这些系统未经食品和药物管理局批准，医疗保健提供者面临着是否支持使用 DIY 系统的患者的决策。本文从患者/家庭和医疗保健提供者的角度讨论了选择和患者自主权的伦理问题。还提出了一套针对医疗保健提供者的建议指南，以供在与希望使用 DIY 系统帮助管理 1 型糖尿病的患者或家庭互动时参考。
