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拉丁美洲血糖监测系统(CGM)评估指标标准化共识声明:专家方法

Consensus statement on standardizing CGM evaluation metrics in Latin America: an expert approach.

作者信息

Scharf Mauro, Feriz Karen, Yepes Carlos, Contreras Álvaro, Lequi Lorena, Sanhueza David, Krakauer Marcio, Márquez Eduardo, Ré Matías, Mehta Roopa

机构信息

Pediatric Endocrinology Unit, Centro de Diabetes Curitiba, Hospital Nossa Senhora das Graças, Curitiba, Brazil.

Endocrinology Service, Fundación Valle del Lili University Hospital, Universidad ICESI, Cali, Colombia.

出版信息

Diabetol Metab Syndr. 2025 Jul 21;17(1):291. doi: 10.1186/s13098-025-01851-0.

Abstract

BACKGROUND

Latin America has no accepted performance standards for continuous glucose monitoring (CGM) technology evaluation. This has resulted in the emergence of various CGM devices in the market that do not meet strict quality, accuracy, reliability or safety standards. CGM systems are crucial for managing diabetes, as they provide frequent glucose measurements and help detect hypoglycemia or hyperglycemia episodes or even predict these events. Ensuring the reliability and accuracy of CGM devices is essential for patient safety. This consensus statement aims to establish a consensus-driven framework of expert recommendations regarding the metrics that should be evaluated to achieve high standards in CGM devices.

MATERIALS AND METHODS

A modified Delphi methodology was employed, engaging endocrinologists, pediatric endocrinologists and diabetologists from Latin America. Experts participated in multiple rounds of surveys and discussions to reach consensus on key characteristics measures, including accuracy thresholds, clinical validation protocols, and post-market surveillance requirements. Quantitative and qualitative data were analyzed to ensure robust recommendations.

RESULTS

The expert panel identified major gaps in existing CGM regulations and established 12 key recommendations and one checklist to align Latin American standards with international best practices. These included the implementation of minimum accuracy thresholds, the adoption of standardized clinical validation protocols, and the enforcement of post-market surveillance measures. The panel also emphasized the importance of patient education, healthcare provider involvement in decision-making, and accessibility to enhance CGM adoption and usability. We underscore the necessity of these measures to improve patient outcomes, patient safety, and regulatory consistency in the region, while also enhancing CGM reliability and accuracy.

CONCLUSION

This consensus statement highlights the urgent need for a standardized metrics to evaluate CGM devices in Latin America. Implementing standardized accuracy requirements, rigorous validation protocols, and enhanced patient education will ensure device reliability, improve clinical outcomes, and foster a more equitable healthcare landscape for diabetes management in the region.

摘要

背景

拉丁美洲没有被广泛接受的用于连续血糖监测(CGM)技术评估的性能标准。这导致市场上出现了各种不符合严格质量、准确性、可靠性或安全标准的CGM设备。CGM系统对于糖尿病管理至关重要,因为它们能提供频繁的血糖测量结果,并有助于检测低血糖或高血糖发作,甚至预测这些事件。确保CGM设备的可靠性和准确性对患者安全至关重要。本共识声明旨在建立一个由共识驱动的专家建议框架,涉及为实现CGM设备的高标准而应评估的指标。

材料与方法

采用了改良的德尔菲法,邀请了来自拉丁美洲的内分泌学家、儿科内分泌学家和糖尿病专家参与。专家们参与了多轮调查和讨论,以就关键特征指标达成共识,包括准确性阈值、临床验证方案和上市后监测要求。对定量和定性数据进行了分析,以确保提出有力的建议。

结果

专家小组确定了现有CGM法规中的主要差距,并制定了12项关键建议和一份清单,以使拉丁美洲的标准与国际最佳实践保持一致。这些建议包括实施最低准确性阈值、采用标准化的临床验证方案以及加强上市后监测措施。专家小组还强调了患者教育、医疗保健提供者参与决策以及提高可及性对于促进CGM的采用和可用性的重要性。我们强调这些措施对于改善该地区患者的治疗效果、患者安全以及监管一致性的必要性,同时也提高CGM的可靠性和准确性。

结论

本共识声明强调了在拉丁美洲迫切需要标准化指标来评估CGM设备。实施标准化的准确性要求、严格的验证方案以及加强患者教育将确保设备的可靠性,改善临床结果,并为该地区糖尿病管理营造更公平的医疗环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb30/12278652/09ffacf1668d/13098_2025_1851_Fig1_HTML.jpg

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