This is an expert position to update a previous algorithm on the most suitable choice of CGM for insulin-treated PwD in light of the recent evidence and clinical practice.
We identified six different clinical scenarios, including type 1 diabetes, type 2 diabetes, pregnancy on intensive insulin therapy, regular physical exercise, new onset of diabetes, and frailty. The use of rtCGM or isCGM is suggested, on the basis of the predominant clinical issue, as suboptimal glucose control or disabling hypoglycemia, regardless of baseline HbA1c or individualized HbA1c target.
The present algorithm may help to select the best CGM device based on patients\' clinical characteristics, needs and clinical context, offering a further opportunity of a \"tailored\" therapy for people with insulin-treated diabetes.
方法:这是一个专家职位,根据最近的证据和临床实践,更新关于胰岛素治疗的PwD的CGM最合适选择的先前算法。
结果:我们确定了六种不同的临床方案,包括1型糖尿病,2型糖尿病,强化胰岛素治疗的妊娠,有规律的体育锻炼,糖尿病新发,和脆弱。建议使用rtCGM或isCGM,基于主要的临床问题,作为血糖控制欠佳或致残性低血糖,无论基线HbA1c或个体化HbA1c目标。
结论:本算法可能有助于根据患者的临床特征选择最佳的CGM装置,需求和临床背景,为胰岛素治疗的糖尿病患者提供“量身定制”治疗的进一步机会。