Future technology-enabled care for diabetes and hyperglycemia in the hospital setting
| Autor: | Paul A Sack, Michelle F. Magee, Alex Montero, Jeffrey S. Dubin |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Insulin pump
medicine.medical_specialty Cost effectiveness Continuous subcutaneous insulin infusion Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Clinical decision support system law.invention 03 medical and health sciences 0302 clinical medicine law Self-management Internal Medicine medicine Medical prescription Intensive care medicine Continuous glucose monitoring Glycemic Inpatients business.industry Diabetes Clinical decision support Patient education Intensive care unit 3. Good health Editorial business |
| Zdroj: | World Journal of Diabetes |
| ISSN: | 1948-9358 |
| DOI: | 10.4239/wjd.v10.i9.473 |
| Popis: | Patients with diabetes are increasingly common in hospital settings where optimal glycemic control remains challenging. Inpatient technology-enabled support systems are being designed, adapted and evaluated to meet this challenge. Insulin pump use, increasingly common in outpatients, has been shown to be safe among select inpatients. Dedicated pump protocols and provider training are needed to optimize pump use in the hospital. Continuous glucose monitoring (CGM) has been shown to be comparable to usual care for blood glucose surveillance in intensive care unit (ICU) settings but data on cost effectiveness is lacking. CGM use in non-ICU settings remains investigational and patient use of home CGM in inpatient settings is not recommended due to safety concerns. Compared to unstructured insulin prescription, a continuum of effective electronic medical record-based support for insulin prescription exists from passive order sets to clinical decision support to fully automated electronic Glycemic Management Systems. Relative efficacy and cost among these systems remains unanswered. An array of novel platforms are being evaluated to engage patients in technology-enabled diabetes education in the hospital. These hold tremendous promise in affording universal access to hospitalized patients with diabetes to effective self-management education and its attendant short/long term clinical benefits. |
| Databáze: | OpenAIRE |
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