菜单
Assesses patient’s understanding of how CGM data (trends, rates of change) differ from discrete SMBG fingerstick values. Triggered when clinicians hear requests to explain lag and trend arrows on CGM or teach the difference between CGM glucose and fingerstick glucose.
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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 | endo-assess-cgm-data-diff-smbg |
| description | Assesses patient’s understanding of how CGM data (trends, rates of change) differ from discrete SMBG fingerstick values. Triggered when clinicians hear requests to explain lag and trend arrows on CGM or teach the difference between CGM glucose and fingerstick glucose. |
Collect device model, wear time, frequency of data review, recent SMBG log, and ask the patient to describe what they see on the CGM screen (numeric value, trend arrows) and what they do with fingerstick results.
Determine if the patient correctly states that CGM measures interstitial glucose with a physiological lag (≈5‑15 min) and displays direction/trend arrows, whereas SMBG provides an instantaneous capillary glucose at a single point in time. If yes, rule in understanding; if not, rule out.
Classify understanding into: (A) Full – explains lag, trend arrows, and uses trend data for insulin decisions; (B) Partial – knows CGM gives a number but confuses with SMBG or misses lag/trend; (C) None – believes CGM and SMBG are identical or does not know what trend arrows mean. Assign the patient to the appropriate tier.
Based on tier: (A) Reinforce and advance to trend‑based dosing strategies; (B) Provide focused teaching on lag, trend interpretation, and calibration requirements; (C) Initiate basic CGM education covering device components, difference from SMBG, and need for confirmatory fingersticks.
Do not assume that wearing CGM equates to understanding; avoid relying solely on self‑report without probing trend interpretation; do not let patients adjust insulin based solely on CGM without confirmatory SMBG if the device requires calibration; watch for alarm fatigue that may cause patients to ignore trend alerts.
A 58‑year‑old with type 1 diabetes wearing a Dexcom G6 reports seeing “120 with an upward arrow.” When asked what the arrow means, they say “My sugar is going up.” They note a fingerstick might differ due to lag and plan to check a fingerstick before dosing if the arrow is steep. This shows partial‑to‑full understanding; the clinician reinforces trend‑based dosing and confirms the calibration schedule.
Source: Diabetes Technology—Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, doi:10.1210/jc.2016-2534