Diabetes Technology Guideline Resources
Full Guideline: Diabetes Technology—Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults
JCEM | September 2016
Anne L. Peters (chair), Andrew J. Ahmann, Tadej Battelino, Alison Evert, Irl B. Hirsch, M. Hassan Murad, William E. Winter, and Howard Wolpert
The 2016 guideline on Diabetes Technology addresses:
- Matching individuals to the best-suited technological solutions for type 1 and type 2 diabetes management
- Deciding when individuals would benefit from continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM)
- Assessing and re-assessing individual psychological status, self-care behavior, and education and training before and during use to ensure adherence and maximize successful adoption of technology
Resources
- App and point of care tools | Endocrine Society
- Clinical Education | ENDO 2016
- Guidelines Pocket Card | Guideline Central
- Patient Resources | Hormone Health Network
- Educational Slide Deck| Endocrine Society
Essential Points
The guideline task force gave its strongest recommendation in support of using CGM technology in individuals with type 1 diabetes who are able and willing to use the monitors. The task force also suggested that CGMs can be used on a short-term, intermittent basis for individuals with type 2 diabetes whose blood glucose is above targeted levels.
The guideline task force also recommended the use of insulin pumps over multiple daily insulin injections in individuals with type 1 diabetes who have not met their A1C goals and are willing and able to use the device. In addition, pumps are recommended for people with frequent hypoglycemia or glucose variability, and those who require increased insulin delivery flexibility or improved satisfaction with their diabetes care. Insulin pump use was suggested for people with type 2 diabetes who were not meeting their glycemic goals.
Summary of Recommendations
+ 1.0 Insulin pump therapy without sensor augmentation
+ 2.0 Insulin pump therapy in type 2 diabetes mellitus
+ 3.0 Insulin pump use in the hospital
+ 4.0 Selection of candidates for insulin pump therapy
+ 5.0 Use of bolus calculators in insulin pump therapy
+ 6.0 Real-time continuous glucose monitors in adult outpatients