Director, Unger Primary Care Concierge Medical Group, Cucamonga, CA. Email:
Am J Manag Care. 2022 Jul;28(4 Suppl):S60-S68. doi: 10.37765/ajmc.2022.89206.
The prevalence of diabetes is growing in the United States at an alarming rate. Early and intensive diagnosis and management of diabetes can reduce the economic burden and improve the societal burden of long-term diabetes-related complications. Healthcare providers practicing in the primary care setting are on the front line of screening, diagnosis, and managing a large majority of persons with diabetes.Until recently, blood glucose monitoring, along with timely A1C measurements, has been the recommended means by which patients can best achieve their prescribed metabolic targets. However, supplies and testing can be costly and burdensome, affecting patient compliance and medication adherence. The recent introduction of integrated diabetes technology including continuous glucose monitoring (CGM) has had a tremendous impact on treating patients to their prescribed glycemic targets safely and efficiently while minimizing their risk of developing treatment-emergent hypoglycemia. Patients who utilize CGM are able to reduce their risk of hospitalizations, minimize work absenteeism, lower their A1C, lower their risk of hypoglycemia, as well as long-term microvascular and macrovascular complications.The American Diabetes Association updated its evidence-based Standards of Medical Care in Diabetes in 2022 around the use of CGM, as has the American Association of Clinical Endocrinology. Because these devices can have a positive effect on the management of persons with diabetes, managed care and healthcare providers should allow technological integration for their patients.
美国的糖尿病患病率正以惊人的速度增长。早期、强化的糖尿病诊断和管理可以减轻经济负担，并改善长期糖尿病相关并发症给社会带来的负担。在初级保健环境中执业的医疗保健提供者处于筛查、诊断和管理大多数糖尿病患者的第一线。直到最近，血糖监测以及及时的 A1C 测量一直是患者实现规定代谢目标的推荐手段。然而，这些检测手段的供应和测试可能既昂贵又繁琐，影响了患者的依从性和药物治疗的依从性。最近推出的包括连续血糖监测（CGM）在内的综合糖尿病技术对安全有效地治疗患者达到规定的血糖目标产生了巨大影响，同时最大限度地降低了治疗中出现低血糖的风险。使用 CGM 的患者能够降低住院风险、减少旷工、降低 A1C、降低低血糖风险以及长期微血管和大血管并发症的风险。美国糖尿病协会（ADA）和美国临床内分泌医师协会（AACE）在 2022 年更新了其基于证据的《糖尿病医学护理标准》，其中包括 CGM 的使用。由于这些设备可以对糖尿病患者的管理产生积极影响，因此管理式医疗和医疗保健提供者应为其患者允许技术整合。
