American Association of Clinical Endocrinology Clinical Practice Guideline: The Use of Advanced Technology in the Management of Persons With Diabetes Mellitus

被引:173
作者
Grunberger, George [1 ]
Sherr, Jennifer [2 ]
Allende, Myriam [3 ]
Blevins, Thomas [4 ]
Bode, Bruce [5 ]
Handelsman, Yehuda [6 ]
Hellman, Richard [7 ]
Lajara, Rosemarie [8 ]
Roberts, Victor Lawrence [9 ]
Rodbard, David [10 ]
Stec, Carla [11 ]
Unger, Jeff [12 ]
机构
[1] Grunberger Diabet Inst, Bloomfield Hills, MI 48302 USA
[2] Yale Univ, Sch Med, New Haven, CT USA
[3] Univ Puerto Rico, Sch Med, San Juan, PR 00936 USA
[4] Texas Diabet & Endocrinol, Austin, TX USA
[5] Atlanta Diabet Associates, Atlanta, GA USA
[6] Metab Inst Amer, Tarzana, CA USA
[7] Univ Missouri, Sch Med, Kansas City, MO 64108 USA
[8] Southern Endocrinol, Plano, TX USA
[9] Univ Cent Florida, Coll Med, Orlando, FL 32816 USA
[10] Biomed Informat Consultants LLC, Potomac, MD USA
[11] Amer Assoc Clin Endocrinol, Jacksonville, FL USA
[12] Unger Primary Care Concierge Med Grp, Rancho Cucamonga, CA USA
关键词
automated insulin dosing; continuous glucose monitoring; continuous subcutaneous insulin infusion; diabetes; diabetes technology; glucose sensors; hybrid closed loop; insulin pumps; sensor-augmented pump; low-glucose suspend; predictive low-glucose suspend; INSULIN PUMP THERAPY; SENSOR-AUGMENTED PUMP; QUALITY-OF-LIFE; MULTIPLE DAILY INJECTIONS; COST-EFFECTIVENESS ANALYSIS; LOW-GLUCOSE-SUSPEND; RANDOMIZED CONTROLLED-TRIAL; PATIENT-REPORTED OUTCOMES; CLOSED-LOOP SYSTEM; GLYCEMIC CONTROL;
D O I
10.1016/j.eprac.2021.04.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To provide evidence-based recommendations regarding the use of advanced technology in the management of persons with diabetes mellitus to clinicians, diabetes-care teams, health care professionals, and other stakeholders. Methods: The American Association of Clinical Endocrinology (AACE) conducted literature searches for relevant articles published from 2012 to 2021. A task force of medical experts developed evidence-based guideline recommendations based on a review of clinical evidence, expertise, and informal consensus, according to established AACE protocol for guideline development. Main Outcome Measures: Primary outcomes of interest included hemoglobin A1C, rates and severity of hypoglycemia, time in range, time above range, and time below range. Results: This guideline includes 37 evidence-based clinical practice recommendations for advanced diabetes technology and contains 357 citations that inform the evidence base. Recommendations: Evidence-based recommendations were developed regarding the efficacy and safety of devices for the management of persons with diabetes mellitus, metrics used to aide with the assessment of advanced diabetes technology, and standards for the implementation of this technology. Conclusions: Advanced diabetes technology can assist persons with diabetes to safely and effectively achieve glycemic targets, improve quality of life, add greater convenience, potentially reduce burden of care, and offer a personalized approach to self-management. Furthermore, diabetes technology can improve the efficiency and effectiveness of clinical decision-making. Successful integration of these technologies into care requires knowledge about the functionality of devices in this rapidly changing field. This information will allow health care professionals to provide necessary education and training to persons accessing these treatments and have the required expertise to interpret data and make appropriate treatment adjustments. (C) 2021 Published by Elsevier Inc. on behalf of the AACE.
引用
收藏
页码:505 / 537
页数:33
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