菜单
Recommends use of hybrid closed-loop pump rather than insulin pump with CGM (without algorithm) or multiple daily injections with CGM for pregnant individuals with type 1 diabetes. Triggered when deciding on insulin delivery methods for pregnant patients with type 1 diabetes.
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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).
基于 SOC 职业分类
正在显示 SKILL.md
| name | pdm-hcl-pump-t1dm |
| description | Recommends use of hybrid closed-loop pump rather than insulin pump with CGM (without algorithm) or multiple daily injections with CGM for pregnant individuals with type 1 diabetes. Triggered when deciding on insulin delivery methods for pregnant patients with type 1 diabetes. |
Confirm pregnancy, type 1 diabetes diagnosis, current insulin delivery method, CGM use, recent glycemic metrics (time in range, hypoglycemia), and patient preferences regarding technology.
Is the individual pregnant with type 1 diabetes? If yes, proceed; if no, this skill does not apply.
Determine whether the patient is currently using an insulin pump with CGM (without algorithm) or multiple daily injections with CGM. If yes, they are a candidate for switching to HCL pump; if already using HCL pump, continue current therapy.
Recommend initiating or continuing a hybrid closed-loop pump system rather than insulin pump with CGM (without algorithm) or multiple daily injections with CGM, after shared decision making and ensuring access to appropriate HCL technology.
Not all HCL algorithms are validated for pregnancy; avoid systems without pregnancy‑specific glucose target capabilities. Ensure clinician expertise in both diabetes management during pregnancy and HCL technology. Monitor for device failure, skin irritation, and over‑reliance on automation without periodic review. Do not use HCL as a substitute for preconception care or regular obstetric follow‑up.
A 30‑week pregnant woman with T1DM using MDI and CGM reports frequent nocturnal hypoglycemia and time in range of 55%. After discussing options, she switches to an HCL pump with a pregnancy‑approved algorithm, achieving time in range of 70% and reduced hypoglycemia within two weeks.
Source: Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society & European Society of Endocrinology, 2025, https://doi.org/10.1210/clinem/dgaf288