7. Diabetes Technology: Standards of Care in Diabetes—2023

Abstract

The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Use of Continuous Glucose Monitors to Manage Type 1 Diabetes Mellitus: Progress, Challenges, and Recommendations

“…Several professional societies have emphasized the role of CGM in type 1 and type 2 diabetes. 6 They also recognize the value of integrating CGM to guide therapy especially in patients with wide glycemic variability. Additional recommendations include using CGM to guide nutrition, physical activity, preventing hypoglycemia, and medication adjustments.…”

“…Additional recommendations include using CGM to guide nutrition, physical activity, preventing hypoglycemia, and medication adjustments. 6 …”

“…Once these devices are prescribed, the provider should make sure that persons with diabetes, as well as any family members or caregivers who will be assisting with diabetes management, undergo initial training and receive continued education in use and interpretation, even after initiation. 6 …”

“…Although implementation of CGM is not without its own challenges, CGM has been recognized as the standard of care for patients with T1D by various professional societies, including the Endocrine Society, American Diabetes Association, and the American Association of Clinical Endocrinology. 6–8 …”

Interpretación del monitoreo continuo de glucosa: una visión práctica

“…El primer paso en el abordaje del paciente usuario de tecnología, es enseñarle la finalidad clínica y objetivos de la herramienta a usar, a través de un programa de educación continua. Basados en las características de cada uno, se ofrece la tecnología y el sistema de monitoreo específico (13,16). El paciente debe brindar información respecto al tiempo de alimentación, cantidad de ingesta de carbohidratos, actividad diaria, ejercicio, dosis de insulina y medicamentos antidiabéticos, e inclusive, circunstancias extenuantes como estrés, viajes, ciclo menstrual, cambios en los parámetros de los sistemas de infusión continua (si este aplica), uso de esteroides y posición al dormir.…”