Sansum Diabetes Research Institute, Santa Barbara, California.
University of California San Diego Veterans Affairs Medical Center, San Diego, California.
Endocr Pract. 2022 Aug;28(8):811-821. doi: 10.1016/j.eprac.2022.04.006. Epub 2022 Apr 19.
The health and economic burden of type 2 diabetes is of global significance. Many people with type 2 diabetes eventually need insulin to help reduce their risk of serious associated complications. However, barriers to the initiation and/or optimization of insulin expose people with diabetes to sustained hyperglycemia. In this review, we investigated how new and future technologies may provide opportunities to help overcome these barriers to the initiation and/or optimization of insulin.
A focused literature search of PubMed and key scientific congresses was conducted. Software tools and devices developed to support the initiation and/or optimization of insulin were identified by manually filtering >300 publications and conference abstracts.
Most software tools have been developed for smartphone platforms. At present, published data suggest that the use of these technologies is associated with equivalent or improved glycemic outcomes compared with standard care, with additional benefits such as reduced time burden and improved knowledge of diabetes among health care providers. However, there remains paucity of good-quality evidence. Most new devices to support insulin therapy help track the dose and timing of insulin.
New digital health tools may help to reduce barriers to optimal insulin therapy. An integrated solution that connects glucose monitoring, dose recording, and titration advice as well as records comorbidities and lifestyle factors has the potential to reduce the complexity and burden of treatment and may improve adherence to titration and treatment, resulting in better outcomes for people with diabetes.
2 型糖尿病的健康和经济负担具有全球性意义。许多 2 型糖尿病患者最终需要胰岛素来帮助降低严重相关并发症的风险。然而，启动和/或优化胰岛素治疗的障碍使糖尿病患者持续处于高血糖状态。在本综述中，我们研究了新的和未来的技术如何提供机会来帮助克服启动和/或优化胰岛素治疗的这些障碍。
对 PubMed 和主要科学大会进行了重点文献检索。通过手动筛选超过 300 篇出版物和会议摘要，确定了用于支持胰岛素启动和/或优化的软件工具和设备。
大多数软件工具都是为智能手机平台开发的。目前，已发表的数据表明，与标准护理相比，这些技术的使用与改善的血糖控制结果相关联，并且具有额外的益处，例如减轻医疗保健提供者的时间负担和提高对糖尿病的了解。然而，高质量证据仍然缺乏。大多数新的胰岛素治疗支持设备有助于跟踪胰岛素的剂量和时间。
新的数字健康工具可能有助于减少优化胰岛素治疗的障碍。连接血糖监测、剂量记录和滴定建议以及记录合并症和生活方式因素的综合解决方案有可能降低治疗的复杂性和负担，并可能提高滴定和治疗的依从性，从而改善糖尿病患者的结局。
