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如何在糖尿病管理中有效使用持续葡萄糖监测:德国专家对现状及未决问题的看法与建议

How to Use Continuous Glucose Monitoring Efficiently in Diabetes Management: Opinions and Recommendations by German Experts on the Status and Open Questions.

作者信息

Thomas Andreas, Haak Thomas, Tombek Astrid, Kulzer Bernhard, Ehrmann Dominic, Kordonouri Olga, Kröger Jens, Schubert-Olesen Oliver, Kolassa Ralf, Siegmund Thorsten, Haller Nicola, Heinemann Lutz

机构信息

Consulting Pirna DE, Pirna, Germany.

Diabetes consulting, Mergentheim Diabetes Center, Bad Mergentheim, Germany.

出版信息

J Diabetes Sci Technol. 2024 Aug 11:19322968241267768. doi: 10.1177/19322968241267768.

Abstract

Today, continuous glucose monitoring (CGM) is a standard diagnostic option for patients with diabetes, at least for those with type 1 diabetes and those with type 2 diabetes on insulin therapy, according to international guidelines. The switch from spot capillary blood glucose measurement to CGM was driven by the extensive and immediate support and facilitation of diabetes management CGM offers. In patients not using insulin, the benefits of CGM are not so well studied/obvious. In such patients, factors like well-being and biofeedback are driving CGM uptake and outcome. Apps can combine CGM data with data about physical activity and meal consumption for therapy adjustments. Personalized data management and coaching is also more feasible with CGM data. The same holds true for digitalization and telemedicine intervention ("virtual diabetes clinic"). Combining CGM data with Smart Pens ("patient decision support") helps to avoid missing insulin boluses or insulin miscalculation. Continuous glucose monitoring is a major pillar of all automated insulin delivery systems, which helps substantially to avoid acute complications and achieve more time in the glycemic target range. These options were discussed by a group of German experts to identify concrete gaps in the care structure, with a view to the necessary structural adjustments of the health care system.

摘要

如今,根据国际指南,连续血糖监测(CGM)是糖尿病患者的一种标准诊断选择,至少对于1型糖尿病患者以及接受胰岛素治疗的2型糖尿病患者来说是如此。从指尖毛细血管血糖测量转向CGM是由CGM为糖尿病管理提供的广泛且即时的支持与便利所推动的。在未使用胰岛素的患者中,CGM的益处尚未得到充分研究/尚不明显。在此类患者中,幸福感和生物反馈等因素正推动着CGM的应用及效果。应用程序可以将CGM数据与身体活动和饮食摄入数据相结合,以进行治疗调整。利用CGM数据进行个性化数据管理和指导也更可行。数字化和远程医疗干预(“虚拟糖尿病诊所”)亦是如此。将CGM数据与智能笔相结合(“患者决策支持”)有助于避免胰岛素剂量遗漏或计算错误。连续血糖监测是所有自动胰岛素输送系统的一个主要支柱,这在很大程度上有助于避免急性并发症,并使血糖处于目标范围内的时间更长。一组德国专家对这些选择进行了讨论,以找出护理结构中的具体差距,以期对医疗保健系统进行必要的结构调整。

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