Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine / New York Presbyterian Hospital, 1305 York Avenue, 4th Floor, New York, NY, 10021, USA.
Curr Diab Rep. 2021 Jan 15;21(2):7. doi: 10.1007/s11892-021-01375-7.
As the prevalence of diabetes mellitus in the USA continues to rise, so does the popularity of diabetes management devices such as continuous glucose monitors (CGMs) and insulin pumps. The use of this technology has been shown to improve outpatient glycemic outcomes and quality of life and oftentimes may be continued in the hospital setting. Our aim is to review the current guidelines and available evidence on the continuation of insulin pumps and CGMs in the inpatient setting.
Patients with diabetes are at higher risk for hospitalizations and complications due to hyper- or hypoglycemia, metabolic co-morbidities, or as seen recently, more severe illness from infections such as SARS-CoV-2. The maintenance of euglycemia is important to decrease both morbidity and mortality in the hospital setting. There is consensus among experts and medical societies that inpatient use of diabetes technology in carefully selected patients with proper institutional protocols is safe and can improve inpatient glycemic outcomes and reduce hypoglycemia. During the COVID-19 pandemic, CGMs played a vital role in managing hyperglycemia in some hospitalized patients. Insulin pumps and CGMs have the potential to transform glycemic management in hospitalized patients. In order for institutions to safely and effectively incorporate these technologies on their inpatient units, hospital-based providers will need to be able to understand how to manage and utilize these devices in their practice in conjunction with diabetes experts.
随着美国糖尿病患病率的持续上升，糖尿病管理设备（如连续血糖监测仪[CGM]和胰岛素泵）的普及程度也在不断提高。该技术的使用已被证明可以改善门诊血糖控制结果和生活质量，并且在医院环境中通常可以继续使用。我们旨在综述目前关于在住院环境中继续使用胰岛素泵和 CGM 的指南和现有证据。
由于高血糖或低血糖、代谢合并症，或最近如 SARS-CoV-2 感染等更严重的疾病，糖尿病患者住院和并发症的风险更高。维持血糖正常对于降低医院环境中的发病率和死亡率非常重要。专家和医学协会达成共识，即精心挑选适当的机构方案的患者在住院期间使用糖尿病技术是安全的，并且可以改善住院血糖控制结果并减少低血糖。在 COVID-19 大流行期间，CGM 在管理某些住院患者的高血糖方面发挥了重要作用。胰岛素泵和 CGM 有可能改变住院患者的血糖管理。为了使机构能够在住院病房安全有效地采用这些技术，医院的提供者将需要能够结合糖尿病专家的意见，了解如何在其日常实践中管理和使用这些设备。
