Tejera-Pérez Cristina, Chico Ana, Azriel-Mira Sharona, Lardiés-Sánchez Beatriz, Gomez-Peralta Fernando
Servicio Endocrinología y Nutriciós, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain.
Servicio Endocrinología y Nutrición, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
Diabetes Ther. 2023 Jul;14(7):1077-1091. doi: 10.1007/s13300-023-01417-1. Epub 2023 May 15.
Undoubtedly, technological advances have revolutionised diabetes management in recent years. The development of advanced closed hybrid loop insulin pumps or continuous glucose monitoring (CGM) systems, among others, have increased the quality of life and improved glycaemic control of people with diabetes. However, only some patients have access to such technology, and only some want to use it. CGM has become much more widespread, but in terms of insulin delivery, most people with type 1 diabetes (T1D) and almost all people with type 2 diabetes (T2D) on insulin therapy are treated with multiple-dose insulin injections (MDI) rather than an insulin pump. For these patients, using connected insulin pens or caps has shown benefits in reducing missed insulin injections and promoting correct administration over time. In addition, using these devices improves the quality of life and user satisfaction. The integration of insulin injection and CGM data facilitates both users and the healthcare team to analyse glucose control and implement appropriate therapeutic changes, reducing therapeutic inertia. This expert's recommendation reviews the characteristics of the devices marketed or in the process of being marketed and their available scientific evidence. Finally, it suggests the profile of users and professionals who would benefit most, the barriers to its generalisation and the changes in the care model that implementing these devices can bring with it.
毫无疑问，近年来技术进步彻底改变了糖尿病管理方式。先进的闭环混合式胰岛素泵或持续葡萄糖监测（CGM）系统等的发展，提高了糖尿病患者的生活质量并改善了血糖控制。然而，只有部分患者能够使用此类技术，而且只有部分患者愿意使用。CGM已变得更为普及，但在胰岛素给药方面，大多数1型糖尿病（T1D）患者以及几乎所有接受胰岛素治疗的2型糖尿病（T2D）患者仍采用多次皮下注射胰岛素（MDI）而非胰岛素泵进行治疗。对于这些患者而言，使用联网胰岛素笔或笔帽已显示出在减少胰岛素漏注以及随着时间推移促进正确给药方面的益处。此外，使用这些设备可提高生活质量和用户满意度。胰岛素注射数据与CGM数据的整合有助于用户和医疗团队分析血糖控制情况并实施适当的治疗调整，减少治疗惰性。本专家建议回顾了已上市或正在上市的设备的特点及其现有科学证据。最后，它指出了将最受益的用户和专业人员的特征、其推广的障碍以及实施这些设备可能带来的护理模式变化。
