Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Nordsjaellands Hospital, Hillerød, Denmark.
Diabetes Metab Res Rev. 2021 Jul;37(5):e3412. doi: 10.1002/dmrr.3412. Epub 2020 Oct 19.
Education is essential in insulin pump therapy, but literature in the field is limited. We systematically reviewed insulin pump education programmes and their effects in two situations as follows: (1) basic education at the start of insulin pump therapy, providing the study design enabled us to separate the effects of insulin pump therapy itself from the effects of education and (2) re-education of experienced pump users. Population: individuals ≥16 years with type 1 diabetes using insulin pumps with or without continuous glucose monitoring. Systematic searches were run in MEDLINE, Embase, CINAHL and ERIC. Original studies reporting an effect of insulin pump education programmes were included if published in English between January 1999 and May 2019. Of 988 potentially relevant studies, 48 were assessed in full text. Nine studies fulfilled the inclusion criteria, including one randomised controlled trial. Educational approaches and settings were sparsely described in all studies, and the content was usually reported as teaching points. Two studies considered basic education, reporting evaluations of knowledge and application skills, and programme satisfaction. The remaining seven studies referred to re-education. Two studies measured severe hypoglycaemic events before and after a re-education intervention, both reporting a significant event reduction. HbA1c decreased significantly in three of four studies. Two studies reported increased knowledge and improved application skills. In conclusion, this review indicates benefits from basic education and from re-education. The strength of the conclusions is limited by the low number of studies and study designs. High-quality studies are needed comparing different approaches for insulin pump education.
教育在胰岛素泵治疗中至关重要，但该领域的文献有限。我们系统地回顾了胰岛素泵教育计划及其在以下两种情况下的效果：（1）胰岛素泵治疗开始时的基础教育，提供了研究设计，使我们能够将胰岛素泵治疗本身的效果与教育的效果分开；（2）有经验的胰岛素泵使用者的再教育。人群：年龄≥16 岁、使用胰岛素泵（有或无连续血糖监测）的 1 型糖尿病患者。在 MEDLINE、Embase、CINAHL 和 ERIC 中进行了系统搜索。如果在 1999 年 1 月至 2019 年 5 月期间以英文发表，并报告了胰岛素泵教育计划效果的原始研究，则纳入研究。在 988 项可能相关的研究中，有 48 项进行了全文评估。9 项研究符合纳入标准，包括一项随机对照试验。所有研究都稀疏地描述了教育方法和环境，内容通常报告为教学要点。有两项研究考虑了基础教育，报告了对知识和应用技能的评估，以及对项目的满意度。其余七项研究涉及再教育。两项研究在再教育干预前后测量了严重低血糖事件，均报告了事件的显著减少。四项研究中有三项 HbA1c 显著降低。两项研究报告了知识的增加和应用技能的改善。总之，这项综述表明基础教育和再教育都有获益。结论的可信度因研究数量和设计有限而受到限制。需要进行高质量的研究，比较胰岛素泵教育的不同方法。
