Biomedical Informatics Consultants LLC, Clinical Biostatistics Department, Potomac, Maryland, USA.
Barbara Davis Center for Diabetes, Departments of Medicine and Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Diabetes Technol Ther. 2021 Mar;23(3):221-226. doi: 10.1089/dia.2021.0030. Epub 2021 Feb 17.
Recent development and availability of several connected insulin pens with digital memory are likely to expand the availability of glucose and insulin metrics that previously had been available only for the much smaller number of people using insulin pumps. It would be highly desirable to standardize data presentations to avoid the chaotic emergence of multiple formats that might reduce the clinical utility of connected pens. We reviewed the literature and analyzed data displays from multiple blood glucose monitoring, continuous glucose monitoring (CGM), insulin pump, and automated insulin delivery systems, and methods for combination of glucose and insulin data. We examined multiple forms of presentation and now propose a prototype for a standardized method for data analysis and display, focusing on the content and format of a one-page dashboard summary for patients on multiple daily injection (MDI) insulin regimens. We propose the following metrics to be included in the one-page report: (A) glucose metrics: simplified glucose distribution in the form of a stacked bar chart showing percentages of time below-, above-, or within-target ranges overall and (optionally) by date, by time of day, or day of the week; (B) insulin metrics: types and doses, and timing of basal and bolus insulin; (C) an enhanced ambulatory glucose profile or "AGP+" showing glucose data points and/or distributions (10th to 90th percentiles), dosages and timing of basal and bolus insulins and (optionally) graphical display of risk of hypoglycemia and hyperglycemia; and (D) user experience regarding technology usage, frequency of alerts for hypo- and hyperglycemia, and information regarding lifestyle, meals, exercise, and sleep, if available; and (E) clinical insights and interpretation. We propose a prototype for a dashboard summary report of glucose, insulin, meals, and activity data intended for providers and patients on MDI using connected pens and CGM. Our goal is to stimulate development of a standardized approach.
最近，一些具有数字记忆功能的胰岛素笔不断发展并投入使用，这可能会扩大血糖和胰岛素数据的可用性，而这些数据以前只提供给使用胰岛素泵的少数人。标准化数据呈现方式将是非常可取的，以避免多种格式的混乱出现，这些格式可能会降低连接笔的临床实用性。
我们回顾了文献，并分析了来自多个血糖监测、连续血糖监测 (CGM)、胰岛素泵和自动胰岛素输送系统的数据显示，以及组合血糖和胰岛素数据的方法。我们检查了多种呈现形式，现在提出了一种标准化数据分析和显示方法的原型，重点是为接受多次每日注射 (MDI) 胰岛素方案的患者提供一页仪表板摘要的内容和格式。
(A) 血糖指标：以堆叠条形图的形式简化血糖分布，显示总体和（可选）按日期、按一天中的时间或按一周中的天数处于目标范围内、高于目标范围或低于目标范围的时间百分比；(B) 胰岛素指标：类型和剂量，以及基础和餐时胰岛素的时间；(C) 增强型动态血糖谱或“AGP+”，显示血糖数据点和/或分布（第 10 百分位至第 90 百分位）、基础和餐时胰岛素的剂量和时间，以及（可选）低血糖和高血糖风险的图形显示；以及(D) 关于技术使用的用户体验、低血糖和高血糖警报的频率，以及如果有相关信息的话，关于生活方式、膳食、运动和睡眠的信息；以及(E) 临床见解和解释。
我们提出了一个用于 MDI 患者的连接笔和 CGM 血糖、胰岛素、膳食和活动数据的仪表板摘要报告原型，供提供者和患者使用。我们的目标是激发标准化方法的开发。
