菜单
Suggests either continuous glucose monitor (CGM) or self-monitoring of blood glucose (SMBG) for pregnant individuals with type 2 diabetes. Triggers include decisions about glucose monitoring methods for pregnant patients with T2DM needing a monitoring strategy.
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For a person with confirmed islet autoantibodies (early-stage type 1 diabetes), state the numerical progression risk to Stage 3 T1D by stage and age, set the age-stratified monitoring frequency (metabolic and HbA1c), apply the ≥10% longitudinal HbA1c rise → OGTT rule, and give the standard risk-modifier and communication framing. Use when a clinician asks how often should I monitor this Stage 1 child, what's the risk of this teenager progressing to insulin, adult with GAD positive what's the 5-year risk, my patient's HbA1c has risen 12% is that important, single autoantibody how often to retest, or how to counsel a family about progression risk. Grounded in Phillip et al. Diabetologia 2024 international staging and monitoring consensus, cross-referenced with Hussain et al 2026 IDF Europe roadmap.
Order and confirm islet autoantibody screening for early-stage type 1 diabetes — which antibodies to test (GAD65, IAA, IA2, ZnT8), sample types (capillary dried blood spot, venous), the mandatory two-sample two-method confirmation protocol, and how to interpret a positive, negative, or single-antibody result. Use when a clinician asks how to screen for early T1D, which islet autoantibodies to order, how to confirm a positive T1D antibody screen, is one autoantibody enough for T1D diagnosis, GAD antibody positive what next, or is running a general population or family-history T1D screening program. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
Classify a person with a positive islet autoantibody screen into a specific stage of type 1 diabetes (At Risk / Stage 1 / Stage 2a / Stage 2b / Stage 3a / Stage 3b / Stage 4) using the international consensus staging framework based on autoantibody count and glycaemic status. Use when a clinician asks how to stage a positive autoantibody screen, what stage of T1D is this, is this early-stage T1D, does this child need insulin yet, is this presymptomatic T1D, does this qualify for teplizumab, or presents a person with any combination of islet autoantibodies + glucose data. Applies across paediatric and adult populations. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
| name | pdm-glucose-monitoring-t2dm |
| description | Suggests either continuous glucose monitor (CGM) or self-monitoring of blood glucose (SMBG) for pregnant individuals with type 2 diabetes. Triggers include decisions about glucose monitoring methods for pregnant patients with T2DM needing a monitoring strategy. |
Confirm pregnancy, type 2 diabetes diagnosis, gestational age, current glucose monitoring method, patient preferences, access to CGM devices, insurance coverage, and ability to perform fingersticks. Review hypoglycemia awareness, insulin regimen, and any skin sensitivities or adhesive issues.
Rule out CGM if patient has significant skin allergy to adhesives, inability to operate the device, or lack of access/training. Rule out sole reliance on SMBG if patient experiences frequent hypoglycemia unawareness, high glycemic variability, or uses insulin pump/CGM-compatible technology.
Stratify by potential CGM benefit: consider CGM for those on intensive insulin therapy, with history of hypoglycemia, high postprandial excursions, or using insulin pump; consider SMBG for those with stable glucose on basal-only therapy, limited dexterity, or preference for fewer devices.
If CGM is accessible and patient prefers real-time trends with alerts, initiate CGM with supplemental SMBG for calibration/confirmation; otherwise, prescribe SMBG fasting and pre/postprandial (typically 4 times daily) with individualized targets.
Do not rely on a single CGM glucose target <140 mg/dL; use pregnancy-specific fasting and postprandial targets. Avoid CGM without SMBG verification if sensor accuracy is questionable. Do not delay insulin adjustments awaiting CGM trends if symptomatic hypoglycemia occurs.
A 30‑year‑old at 14 weeks gestation with T2DM on basal‑bolus insulin reports nocturnal hypoglycemia and variable postprandial spikes. She has insurance coverage for CGM and prefers fewer fingersticks. After training, she starts rtCGM with SMBG twice daily for calibration, targeting fasting <95 mg/dL and 1‑hour postprandial <140 mg/dL.
Source: Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, 2025, DOI: 10.1210/clinem/dgaf288