Rickards Gabriella M, Harrod Julia C, Del Valle Kayla, Caballero A Enrique, Palermo Nadine E, McDonnell Marie E
Brigham and Women's Hospital, Boston, MA, USA.
J Diabetes Sci Technol. 2024 Nov 18:19322968241288917. doi: 10.1177/19322968241288917.
While continuous glucose monitoring (CGM) has transformed the care of people with diabetes (PWD) in the ambulatory setting, there continue to be significant barriers to access. With CGM on the horizon in the acute care setting, it is important to consider the potential for this shift to improve ambulatory CGM access to those at the highest risk of morbidity and mortality.
In this commentary, we review the existing literature on the specific barriers to CGM access for individuals with diabetes in the United States including racial disparities, provider bias, cost and shortage of specialty diabetes care. Key areas explored include the importance of CGM in diabetes management, the consequences of disparities in access to CGM, and leveraging the inpatient setting to promote equitable care and better outcomes for PWD.
We present a vision for a new care model, which leverages the transition of care from the hospital to successfully incorporate CGM into the discharge plan.
Given that CGM utilization is associated with improved outcomes and reduced rates of hospitalization and emergency department visits, a care model that facilitates CGM access upon transition from inpatient to ambulatory care can enhance health equity and quality of life for people with diabetes.
虽然持续葡萄糖监测(CGM)改变了糖尿病患者(PWD)在门诊环境中的护理方式,但获取该技术仍存在重大障碍。随着CGM即将应用于急性护理环境,重要的是要考虑这种转变是否有可能改善那些发病和死亡风险最高的人群对门诊CGM的获取。
在这篇评论中,我们回顾了关于美国糖尿病患者获取CGM的具体障碍的现有文献,包括种族差异、医疗服务提供者的偏见、成本以及糖尿病专科护理的短缺。探讨的关键领域包括CGM在糖尿病管理中的重要性、获取CGM方面的差异所带来的后果,以及利用住院环境为糖尿病患者促进公平护理和更好的治疗效果。
我们提出了一种新护理模式的设想,该模式利用从医院到门诊的护理过渡,成功地将CGM纳入出院计划。
鉴于CGM的使用与改善治疗效果、降低住院率和急诊就诊率相关,一种在从住院护理过渡到门诊护理时便于获取CGM的护理模式可以提高糖尿病患者的健康公平性和生活质量。