Division of Endocrinology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Division of Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
J Diabetes Sci Technol. 2023 Sep;17(5):1265-1273. doi: 10.1177/19322968221088267. Epub 2022 Apr 11.
Diabetes clinicians are key facilitators of continuous glucose monitoring (CGM) provision, but data on provider behavior related to CGM use and CGM generated data are limited.
We conducted a national survey of providers caring for people with diabetes on CGM-related opinions, facilitators and barriers to prescription, and data review practices.
Of 182 survey respondents, 73.2% worked at academic centers, 70.6% were endocrinologists, and 70.7% practiced in urban settings. Nearly 70% of providers reported CGM use in the majority of their patients with type 1 diabetes. Half of the providers reported CGM use in 10% to 50% of their patients with type 2 diabetes. All respondents believed CGM improved quality of life and could optimize diabetes control. We found no differences in reported rates of CGM use based on providers' years of experience, patient volume, practice setting, or clinic type. Most providers reviewed CGM data each visit (97.7%) and actively involved patients in the data interpretation (98.8%). Only 14.1% of clinicians reported reviewing CGM data without any prompting from patients or their family members outside of visits. Most providers (80.7%) reported their CGM data review was valued by patients although only half reported having adequate time (45.1%) or an efficient process (56.1%) to do so.
Despite uniform support for CGM by providers, ongoing challenges related to cost, insurance coverage, and difficulties with prescription were major barriers to CGM use. Increased use of CGM in appropriate populations will necessitate improvements in data access and integration, clearly defined workflows, and decreased administrative burden to obtain CGM.
糖尿病临床医生是持续血糖监测（CGM）提供的关键推动者，但有关提供者与 CGM 使用相关的行为以及 CGM 生成数据的信息有限。
我们对从事 CGM 相关意见、处方的促进者和障碍以及数据审查实践的糖尿病护理提供者进行了全国性调查。
在 182 名调查受访者中，73.2%的人在学术中心工作，70.6%是内分泌科医生，70.7%的人在城市环境中工作。近 70%的提供者报告说，他们的大多数 1 型糖尿病患者都在使用 CGM。一半的提供者报告说，他们的 2 型糖尿病患者中有 10%至 50%在使用 CGM。所有受访者都认为 CGM 提高了生活质量，并可以优化糖尿病控制。我们没有发现根据提供者的工作经验、患者数量、实践环境或诊所类型，报告的 CGM 使用率存在差异。大多数提供者（97.7%）每次就诊都会审查 CGM 数据，并积极让患者参与数据解读（98.8%）。只有 14.1%的临床医生报告说，他们在就诊之外没有任何患者或其家属的提示就审查了 CGM 数据。尽管只有一半的人报告有足够的时间（45.1%）或有效的流程（56.1%）来做到这一点，但大多数提供者（80.7%）表示患者重视他们的 CGM 数据审查。
尽管提供者普遍支持 CGM，但与成本、保险覆盖范围和处方困难相关的持续挑战是 CGM 使用的主要障碍。在适当的人群中增加 CGM 的使用将需要改善数据访问和整合、明确界定工作流程以及减少获得 CGM 的行政负担。
