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对于经过认证的糖尿病护理和教育专家而言,胰岛素剂量调整政策:安全有效
Jeannine C Leverenz1, Lauren Horton1, Barry Conrad1
1Lucile Packard Children's Hospital, Division of Pediatric Endocrinology, Palo Alto, CA, United States.
Journal of clinical & translational endocrinology
|November 24, 2025
概括
经过认证的糖尿病护理和教育专家 (CDCES) 使用远程连续血糖监测 (CGM) 数据安全地调整了新发型1型糖尿病的青少年的胰岛素剂量. 该方案改善了患者的治疗结果,可以被其他中心采用.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 糖尿病 技术 技术
- 临床协议开发 临床协议开发
背景情况:
- 患有新发型1型糖尿病的年轻人需要密集管理以获得最佳的血糖控制.
- 持续血糖监测 (CGM) 为糖尿病管理提供了宝贵的数据.
- 远程患者监测和专家干预可以提高糖尿病护理的提供.
研究的目的:
- 用CGM数据描述和评估一项用于认证糖尿病护理和教育专家 (CDCES) 的协议,以便使用CGM数据对新发型1型糖尿病的青少年进行远程胰岛素剂量调整.
- 评估CDCES主导的胰岛素剂量调整在实现血糖目标方面的安全性和有效性.
- 提供数据支持的协议,以便在糖尿病中心更广泛地采用.
主要方法:
- 为CDCES制定了一项协议,根据CGM数据和患者信息调整胰岛素剂量,并与儿科内分泌学家协商.
- 远程CGM数据被审查,剂量调整和行为建议通过安全的门户消息传达.
- 133名患有新发型1型糖尿病的参与者被远程监测,第一年共交换了1564条信息.
主要成果:
- 大多数远程消息是由低时间内范围 (TIR),低血糖,下降的TIR或不足的CGM磨损引发的.
- 有3次严重低血糖症,没有一个与CDCES剂量协议有关.
- 一年后,平均时间<70 mg/dl为<2%,64%的参与者实现了A1C目标<7%.
结论:
- 一个由CDCES领导的远程胰岛素剂量调整协议在管理青少年新发型1型糖尿病时是安全有效的.
- 疾病预防糖尿病和糖尿病管理中心 (CDCES) 可以在其认证的顶端运作,通过积极的糖尿病管理来改善患者的治疗结果.
- 该协议促进了患者与医疗服务提供者的互动,可以在其他糖尿病中心实施.
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