Hughes Michael S, Pasquel Francisco J, Davis Georgia M, Lal Rayhan A, Buckingham Bruce A, Boughton Charlotte K, Brown Sue A, Bally Lia
Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University, Stanford, California, USA.
Division of Endocrinology, Metabolism, and Lipids, Emory University School of Medicine, Atlanta, Georgia, USA.
Diabetes Technol Ther. 2025 Mar;27(3):217-242. doi: 10.1089/dia.2024.0343. Epub 2024 Dec 2.
The introduction of automated insulin delivery (AID) systems represents a significant advancement in diabetes care, offering substantial benefits in outpatient settings. Although clinical studies suggest that these systems can also help improve glycemic control in acutely ill patients, several barriers remain for the actual implementation and use of these technologies in clinical practice. Three main contexts for inpatient use are addressed, including: (a) continuation of personal AID systems, (b) initiation of AID during hospitalization, and (c) initiation of AID systems at discharge. A research road map with immediate to long-term actions is presented. Initially, it calls for clinical studies assessing in-hospital efficacy, safety, and utility, addressing specific patient needs and health care operational impacts. Midterm, it focuses on practical integration, simplifying AID use, ensuring electronic health record compatibility, clarifying regulatory uncertainties, and supporting health care professionals and patients. Long-term goals include system optimizations and policy advocacy for in-hospital AID use.
自动胰岛素输送（AID）系统的引入代表了糖尿病护理领域的一项重大进展，在门诊环境中带来了诸多益处。尽管临床研究表明这些系统也有助于改善急性病患者的血糖控制，但在临床实践中实际实施和使用这些技术仍存在一些障碍。本文探讨了住院患者使用AID的三种主要情况，包括：（a）个人AID系统的延续，（b）住院期间启动AID，以及（c）出院时启动AID系统。本文还提出了一个包含近期到长期行动的研究路线图。首先，需要开展临床研究来评估住院期间的疗效、安全性和实用性，解决特定患者需求和医疗保健运营影响。中期，重点在于实际整合、简化AID的使用、确保电子健康记录兼容性、澄清监管不确定性以及支持医护人员和患者。长期目标包括系统优化和住院AID使用的政策倡导。
