Marrero David G, Parkin Christopher G, Aleppo Grazia, Hirsch Irl B, McGill Janet, Galindo Rodolfo J, Kruger Davida F, Levy Carol J, Carlson Anders L, Umpierrez Guillermo E
CGParkin Communications, Inc, 2675 Windmill Pkwy, Ste 2721, Henderson, NV 89074. Email:
Am J Manag Care. 2025 Apr 1;31(4):e102-e112. doi: 10.37765/ajmc.2025.89725.
To discuss the current state of diabetes care in America, the value and utility of innovative diabetes technologies, barriers to access to quality diabetes care and technologies, and how a value-based model of diabetes care can improve outcomes and reduce costs.
Narrative review of the current state of diabetes care in America and use of diabetes technologies such as continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems.
An internet search of relevant studies and government reports was conducted.
Numerous studies have shown that use of CGM and AID improves glycemia, diabetes-related events, and health care resource utilization and lowers overall health care costs. Despite these demonstrated benefits, the majority of individuals with diabetes are not achieving their glycemic goals. Although many of these individuals have limited access to these technologies due to restrictive coverage eligibility criteria, significant disparities exist in technology use within racial/ethnic minority populations and communities of lower socioeconomic status. Transitioning to a value-based approach to diabetes care supports the Quintuple Aim framework.
Shifting our current health care delivery paradigm from the traditional volume-based, fee-for-service model to a value-based model that takes a proactive approach could improve patient outcomes and overall quality of life while helping to reduce the long-term costs of diabetes care.
探讨美国糖尿病护理的现状、创新糖尿病技术的价值和效用、获得优质糖尿病护理及技术的障碍，以及基于价值的糖尿病护理模式如何改善治疗效果并降低成本。
对美国糖尿病护理现状以及连续血糖监测（CGM）和自动胰岛素输送（AID）系统等糖尿病技术的使用情况进行叙述性综述。
对相关研究和政府报告进行互联网搜索。
大量研究表明，使用CGM和AID可改善血糖水平、减少糖尿病相关事件、提高医疗资源利用率并降低总体医疗成本。尽管有这些已证实的益处，但大多数糖尿病患者并未实现其血糖目标。由于覆盖资格标准严格，许多患者难以获得这些技术，而且在种族/族裔少数群体和社会经济地位较低的社区中，技术使用存在显著差异。向基于价值的糖尿病护理方法转变有助于实现“五重目标”框架。
将我们当前的医疗服务模式从传统的基于数量的收费服务模式转变为采取积极主动方法的基于价值的模式，可改善患者治疗效果和总体生活质量，同时有助于降低糖尿病护理的长期成本。
