1 型糖尿病管理中胰岛素泵设置的调整：Advisor Pro 设备与医师建议的比较。
Adjustment of Insulin Pump Settings in Type 1 Diabetes Management: Advisor Pro Device Compared to Physicians' Recommendations.
机构信息
The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah, Tikva, Israel.
DreaMed Diabetes Ltd, Petah Tiqva, Israel.
出版信息
J Diabetes Sci Technol. 2022 Mar;16(2):364-372. doi: 10.1177/1932296820965561. Epub 2020 Oct 26.
AIMS
To compare insulin dose adjustments made by physicians to those made by an artificial intelligence-based decision support system, the Advisor Pro, in people with type 1 diabetes (T1D) using an insulin pump and self-monitoring blood glucose (SMBG).
METHODS
This was a multinational, non-interventional study surveying 17 physicians from 11 countries. Each physician was asked to provide insulin dose adjustments for the settings of the pump including basal rate, carbohydrate-to-insulin ratios (CRs), and correction factors (CFs) for 15 data sets of pumps and SMBG of people with T1D (mean age 18.4 ± 4.8 years; eight females; mean glycated hemoglobin 8.2% ± 1.4% [66 ± 11mmol/mol]). The recommendations were compared among the physicians and between the physicians and the Advisor Pro. The study endpoint was the percentage of comparison points for which there was an agreement on the direction of insulin dose adjustments.
RESULTS
The percentage (mean ± SD) of agreement among the physicians on the direction of insulin pump dose adjustments was 51.8% ± 9.2%, 54.2% ± 6.4%, and 49.8% ± 11.6% for the basal, CR, and CF, respectively. The automated recommendations of the Advisor Pro on the direction of insulin dose adjustments were comparable )49.5% ± 6.4%, 55.3% ± 8.7%, and 47.6% ± 14.4% for the basal rate, CR, and CF, respectively( and noninferior to those provided by physicians. The mean absolute difference in magnitude of change between physicians was 17.1% ± 13.1%, 14.6% ± 8.4%, and 23.9% ± 18.6% for the basal, CR, and CF, respectively, and comparable to the Advisor Pro 11.7% ± 9.7%, 10.1% ± 4.5%, and 25.5% ± 19.5%, respectively, significant for basal and CR.
CONCLUSIONS
Considerable differences in the recommendations for changes in insulin dosing were observed among physicians. Since automated recommendations by the Advisor Pro were similar to those given by physicians, it could be considered a useful tool to manage T1D.
目的
比较 11 个国家的 17 名医生对使用胰岛素泵和自我监测血糖（SMBG）的 1 型糖尿病（T1D）患者进行的胰岛素剂量调整，以及人工智能决策支持系统 Advisor Pro 所做的剂量调整。
方法
这是一项多中心、非干预性研究，调查了来自 11 个国家的 17 名医生。每位医生被要求根据 15 个 T1D 患者的泵和 SMBG 数据集的设置（基础率、碳水化合物与胰岛素比值（CRs）和校正因子（CFs）），为 15 个泵和 SMBG 数据集的患者提供胰岛素剂量调整建议（平均年龄 18.4 ± 4.8 岁；8 名女性；平均糖化血红蛋白 8.2% ± 1.4%[66 ± 11mmol/mol]）。将这些建议与医生之间以及医生与 Advisor Pro 之间进行比较。研究终点是比较胰岛素剂量调整方向的一致性百分比。
结果
医生之间在胰岛素泵剂量调整方向上的一致性百分比分别为基础率 51.8% ± 9.2%、CR 54.2% ± 6.4%和 CF 49.8% ± 11.6%。Advisor Pro 对胰岛素剂量调整方向的自动建议与医生的建议相当（基础率 49.5% ± 6.4%、CR 55.3% ± 8.7%和 CF 47.6% ± 14.4%），并且不逊于医生的建议。医生之间在调整幅度上的平均绝对差异分别为基础率 17.1% ± 13.1%、CR 14.6% ± 8.4%和 CF 23.9% ± 18.6%，与 Advisor Pro 的 11.7% ± 9.7%、CR 10.1% ± 4.5%和 CF 25.5% ± 19.5%相当，基础率和 CR 差异显著。
结论
医生对胰岛素剂量调整的建议存在明显差异。由于 Advisor Pro 的自动建议与医生的建议相似，因此它可以被认为是管理 T1D 的有用工具。
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