Kietaibl Antonia-Therese, Schütz-Fuhrmann Ingrid, Bozkurt Latife, Frühwald Lisa, Rami-Merhar Birgit, Fröhlich-Reiterer Elke, Hofer Sabine E, Tauschmann Martin, Resl Michael, Hörtenhuber Thomas, Stechemesser Lars, Winhofer Yvonne, Riedl Michaela, Zlamal-Fortunat Sandra, Eichner Marlies, Stingl Harald, Schelkshorn Christian, Weitgasser Raimund, Rega-Kaun Gersina, Köhler Gerd, Mader Julia K
5. Medizinische Abteilung für Endokrinologie, Rheumatologie und Akutgeriatrie, Klinik Ottakring, Wien, Österreich.
Verein zur Förderung der wissenschaftlichen Forschung am Wilhelminenspital, Wien, Österreich.
Wien Klin Wochenschr. 2024 Jul;136(Suppl 9):467-477. doi: 10.1007/s00508-024-02400-x. Epub 2024 Aug 28.
People living with diabetes mellitus can be supported in the daily management by diabetes technology with automated insulin delivery (AID) systems to reduce the risk of hypoglycemia and improve glycemic control as well as the quality of life. Due to barriers in the availability of AID-systems, the use and development of open-source AID-systems have internationally increased. This technology provides a necessary alternative to commercially available products, especially when approved systems are inaccessible or insufficiently adapted to the specific needs of the users. Open-source technology is characterized by worldwide free availability of codes on the internet, is not officially approved and therefore the use is on the individual's own responsibility. In the clinical practice a lack of expertise with open-source AID technology and concerns about legal consequences, lead to conflict situations for health-care professionals (HCP), sometimes resulting in the refusal of care of people living with diabetes mellitus. This position paper provides an overview of the available evidence and practical guidance for HCP to minimize uncertainties and barriers. People living with diabetes mellitus must continue to be supported in education and diabetes management, independent of the chosen diabetes technology including open-source technology. Check-ups of the metabolic control, acute and chronic complications and screening for diabetes-related diseases are necessary and should be regularly carried out, regardless of the chosen AID-system and by a multidisciplinary team with appropriate expertise.
糖尿病患者在日常管理中可借助糖尿病技术及自动胰岛素输注(AID)系统获得支持,以降低低血糖风险,改善血糖控制及生活质量。由于AID系统的可及性存在障碍,开源AID系统在国际上的使用和开发有所增加。这项技术为市售产品提供了必要的替代方案,特别是在无法获得获批系统或现有系统无法充分满足用户特定需求的情况下。开源技术的特点是代码在互联网上全球免费可用,未经官方批准,因此使用由个人自行负责。在临床实践中,缺乏开源AID技术专业知识以及对法律后果的担忧,给医护人员(HCP)带来了冲突情况,有时导致拒绝为糖尿病患者提供护理。本立场文件概述了现有证据,并为医护人员提供了实用指南,以尽量减少不确定性和障碍。糖尿病患者必须在教育和糖尿病管理方面持续获得支持,无论选择何种糖尿病技术,包括开源技术。无论选择何种AID系统,都应由具备适当专业知识的多学科团队定期进行代谢控制、急慢性并发症检查以及糖尿病相关疾病筛查。