Lewis Dana M, Hussain Sufyan
OpenAPS, Seattle, WA, USA.
Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Diabetes Ther. 2022 Sep;13(9):1683-1699. doi: 10.1007/s13300-022-01299-9. Epub 2022 Aug 1.
As increasing numbers of people with insulin-managed diabetes use automated insulin delivery (AID) systems or seek such technologies, healthcare providers are faced with a steep learning curve. Healthcare providers need to understand how to support these technologies to help inform shared decision making, discussing available options, implementing them in the clinical setting, and guiding users in special situations. At the same time, there is a growing diversity of commercial and open source automated insulin delivery systems that are evolving at a rapid pace. This practical guide seeks to provide a conversational framework for healthcare providers to first understand and then jointly assess AID system options with users and caregivers. Using this framework will help HCPs in learning how to evaluate potential new commercial or open source AID systems, while also providing a guide for conversations to help HCPs to assess the readiness and understanding of users for AID systems. The choice of an AID system is not as simple as whether the system is open source or commercially developed, and indeed there are multiple criteria to assess when choosing an AID system. Most importantly, the choices and preferences of the person living with diabetes should be at the center of any decision around the ideal automated insulin delivery system or any other diabetes technology. This framework highlights issues with AID use that may lead to burnout or perceived failures or may otherwise cause users to abandon the use of AID. It discusses the troubleshooting of basic AID system operation and discusses more advanced topics regarding how to maximize the time spent on AID systems, including how to optimize settings and behaviors for the best possible outcomes with AID technology for people with insulin-requiring diabetes. This practical approach article demonstrates how healthcare providers will benefit from assessing and better understanding all available AID system options to enable them to best support each individual.
随着越来越多使用胰岛素治疗的糖尿病患者使用自动胰岛素输送（AID）系统或寻求此类技术，医疗保健提供者面临着陡峭的学习曲线。医疗保健提供者需要了解如何支持这些技术，以帮助进行共同决策，讨论可用选项，在临床环境中实施这些技术，并在特殊情况下指导用户。与此同时，商业和开源自动胰岛素输送系统的种类越来越多，且发展迅速。本实用指南旨在为医疗保健提供者提供一个交流框架，以便他们首先了解，然后与用户和护理人员共同评估AID系统选项。使用这个框架将帮助医疗保健专业人员学习如何评估潜在的新商业或开源AID系统，同时也为交流提供指导，以帮助医疗保健专业人员评估用户对AID系统的准备情况和理解程度。选择AID系统并不像判断该系统是开源还是商业开发那么简单，实际上，选择AID系统时需要评估多个标准。最重要的是，糖尿病患者的选择和偏好应成为围绕理想的自动胰岛素输送系统或任何其他糖尿病技术的任何决策的核心。这个框架突出了AID使用中可能导致倦怠或感知失败，或可能导致用户放弃使用AID的问题。它讨论了AID系统基本操作的故障排除，并讨论了更高级的主题，即如何最大限度地利用在AID系统上花费的时间，包括如何优化设置和行为，以便使用AID技术为需要胰岛素治疗的糖尿病患者带来最佳可能的结果。这篇实用方法文章展示了医疗保健提供者将如何从评估和更好地理解所有可用的AID系统选项中受益，从而能够最好地支持每一个人。
