Diabetes-Related Technologies for Inpatient Management: Insulin Pump, Continuous Glucose Monitoring Systems, and Hybrid Closed-Loop Systems
摘要
Over the last decade, continuous subcutaneous insulin infusion (CSII) pumps, continuous glucose monitoring (CGM) systems, and more recently, hybrid closed-loop systems (HCL) have been widely used for the management of type 1 and sometimes type 2 diabetes. The American Diabetes Association (ADA) advocates for patients to continue using their diabetes-related technologies such as insulin pump, CGM and HCL systems in hospitals, provided they are capable of self-care and adequate supervision is ensured. ADA also encourages hospitals to develop policies and protocols to facilitate the inpatient use of both individual- and hospital-owned diabetes technology and have expert staff available for safe implementation. Although research on the use of diabetes-related technologies in hospitals has increased in recent years, information remains sparse. Safe management of hospitalized patients using diabetes-related technologies requires thorough planning, education of clinicians and nursing staff, and effective communication between the treating team and the patient. It is imperative for health-care providers to be trained in identifying which patients on diabetes-related technologies treatment are suitable candidates for continued use of their own systems in the hospital setting and for health-care institutions to establish clear policies and procedures for self-use of insulin pumps, CGM, and HCL systems.