Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness. Clinician Research Summary.

摘要

In response to a public request regarding the benefits and harms of current modes of intensive insulin therapy (continuous subcutaneous insulin infusion (CSII) vs. multiple daily injections (MDI)) and modes of blood glucose monitoring (real-time continuous glucose monitoring (rt-CGM) vs. self-monitoring of blood glucose (SMBG)), the Agency for Healthcare Research and Quality (AHRQ) contracted with the Evidence-based Practice Center at Johns Hopkins University to conduct a systematic review of these modalities. Forty-one studies in 44 publications met the inclusion criteria. Outcomes including glycemic control, hypoglycemia, quality of life, and clinical outcomes were assessed in individuals with type 1 diabetes, type 2 diabetes, or pre-existing diabetes in pregnancy. The review did not include pregnant women with gestational diabetes and patients with maturity-onset diabetes of the young in its evaluation. This summary is provided to assist in decisionmaking along with consideration of a patients values and preferences. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines.