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糖尿病技术——成人持续皮下胰岛素输注治疗与持续葡萄糖监测:内分泌学会临床实践指南

Diabetes Technology-Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline.

作者信息

Peters Anne L, Ahmann Andrew J, Battelino Tadej, Evert Alison, Hirsch Irl B, Murad M Hassan, Winter William E, Wolpert Howard

机构信息

Keck School of Medicine (A.L.P.), University of Southern California, Los Angeles, California 90033; Harold Schnitzer Diabetes Health Center (A.J.A.), Oregon Health & Science University, Portland, Oregon 97239; Department of Medicine (T.B.), University of Ljubljana and University Children's Hospital, 1104 Ljubljana, Slovenia; Endocrine and Diabetes Care Center (A.E., I.B.H.), University of Washington Medical Center, Seattle, Washington 98195; Mayo Clinic Evidence-based Practice Center (M.H.M.), Rochester, Minnesota 55905; UF Diabetes Institute (W.E.W.), University of Florida, Gainesville, Florida 32611; and Joslin Diabetes Center (H.W.), Harvard Medical School, Boston, Massachusetts 02115.

出版信息

J Clin Endocrinol Metab. 2016 Nov;101(11):3922-3937. doi: 10.1210/jc.2016-2534. Epub 2016 Sep 2.

Abstract

OBJECTIVE

To formulate clinical practice guidelines for the use of continuous glucose monitoring and continuous subcutaneous insulin infusion in adults with diabetes.

PARTICIPANTS

The participants include an Endocrine Society-appointed Task Force of seven experts, a methodologist, and a medical writer. The American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology co-sponsored this guideline.

EVIDENCE

The Task Force developed this evidence-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned one systematic review and used the best available evidence from other published systematic reviews and individual studies.

CONSENSUS PROCESS

One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the American Association for Clinical Chemistry, the American Association of Diabetes Educators, and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines.

CONCLUSIONS

Continuous subcutaneous insulin infusion and continuous glucose monitoring have an important role in the treatment of diabetes. Data from randomized controlled trials are limited on the use of medical devices, but existing studies support the use of diabetes technology for a wide variety of indications. This guideline presents a review of the literature and practice recommendations for appropriate device use.

摘要

目的

制定糖尿病成人患者使用持续葡萄糖监测和持续皮下胰岛素输注的临床实践指南。

参与者

参与者包括内分泌学会任命的由七名专家组成的特别工作组、一名方法学家和一名医学撰写人。美国临床化学协会、美国糖尿病教育者协会和欧洲内分泌学会共同赞助了本指南。

证据

特别工作组使用推荐分级、评估、制定和评价系统制定了本循证指南,以描述推荐的强度和证据的质量。特别工作组委托进行了一项系统评价,并使用了其他已发表的系统评价和个别研究中的最佳现有证据。

共识过程

通过一次小组会议、几次电话会议和电子邮件通信达成了共识。内分泌学会、美国临床化学协会、美国糖尿病教育者协会和欧洲内分泌学会的委员会及成员对这些指南的初稿进行了审查并提出了意见。

结论

持续皮下胰岛素输注和持续葡萄糖监测在糖尿病治疗中具有重要作用。关于医疗器械使用的随机对照试验数据有限,但现有研究支持将糖尿病技术用于多种适应症。本指南对文献进行了综述,并针对适当使用设备提出了实践建议。

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