Abstract:
OBJECTIVE: There have been many developments in diabetes technology in recent years, with continuous glucose monitoring (CGM), insulin pump therapy (CSII) and automated insulin delivery (AID) becoming progressively accepted in outpatient diabetes care. However, the use of such advanced diabetes technology in the inpatient setting is still limited for several reasons, including logistical challenges and staff training needs. On the other hand, hospital settings with altered diet and stress-induced hyperglycemia often pose challenges to tight glycemic control using conventional treatment tools. Integrating smarter glucose monitoring and insulin delivery devices into the increasingly technical hospital environment could reduce diabetes-related morbidity and mortality. This narrative review describes the most recent literature on the use of diabetes technology in the hospital and suggests avenues for further research.
RESULTS: Advanced diabetes technology has the potential to improve glycemic control in hospitalized people with and without diabetes, and could add particular value in certain conditions, such as nutrition therapy or perioperative management. Taken together, CGM allows for more accurate and patient-friendly follow-up and ad hoc titration of therapy. AID may also provide benefits, including improved glycemic control and reduced nursing workload. Before advanced diabetes technology can be used on a large scale in the hospital, further research is needed on efficacy, accuracy and safety, while implementation factors such as cost and staff training must also be overcome.
摘要:
目的:近年来糖尿病技术有了很多进展,连续血糖监测(CGM),胰岛素泵治疗(CSII)和自动胰岛素给药(AID)在门诊糖尿病治疗中逐渐被接受。然而,由于几个原因,这种先进的糖尿病技术在住院患者中的使用仍然受到限制,包括后勤挑战和员工培训需求。另一方面,改变饮食和应激性高血糖的医院环境通常对使用常规治疗工具进行严格的血糖控制构成挑战.将更智能的葡萄糖监测和胰岛素输送设备集成到技术日益提高的医院环境中可以降低与糖尿病相关的发病率和死亡率。这篇叙述性综述描述了有关在医院中使用糖尿病技术的最新文献,并提出了进一步研究的途径。
结果:先进的糖尿病技术有可能改善有和没有糖尿病的住院患者的血糖控制,并且可以在某些条件下增加特定的价值,如营养治疗或围手术期管理。一起来看,CGM允许更准确和患者友好的随访和治疗的临时滴定。AID也可能提供好处,包括改善血糖控制和减少护理工作量。在先进的糖尿病技术可以在医院大规模使用之前,疗效需要进一步研究,准确性和安全性,同时还必须克服成本和员工培训等实施因素。