菜单
Recommends using continuous glucose monitoring instead of fingerstick self-monitoring for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Use when a clinician evaluates glucose monitoring options for T1D on MDIs or manages hypoglycemia-prone T1D patients.
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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
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| name | endo-cgm-vs-smbg-t1d-mdi |
| description | Recommends using continuous glucose monitoring instead of fingerstick self-monitoring for type 1 diabetes patients on multiple daily injections to reduce hypoglycemia risk. Use when a clinician evaluates glucose monitoring options for T1D on MDIs or manages hypoglycemia-prone T1D patients. |
Confirm diagnosis of type 1 diabetes, current insulin regimen (multiple daily injections), history of hypoglycemia or hypoglycemia unawareness, patient’s ability to use CGM device, access to supplies, and interest in real-time glucose data.
Rule in: Patient has T1D and is using MDIs. Rule out: Patient is not on MDIs (e.g., using insulin pump) or does not have T1D; if ruled out, consider alternative monitoring strategies per other guidelines.
Stratify by hypoglycemia risk: higher priority for CGM in patients with hypoglycemia unawareness, frequent nocturnal hypoglycemia, fear of hypoglycemia, or impaired awareness of hypoglycemia (IAH); lower priority but still recommended for all T1D on MDIs.
Recommend initiating real-time CGM rather than SMBG by fingerstick; provide comprehensive CGM education and ensure continued access to SMBG for sensor validation, warm‑up periods, and symptom‑glucose mismatches.
Do not rely solely on CGM without SMBG backup; do not skip patient education on device use and troubleshooting; avoid CGM use if patient cannot afford supplies or has uncontrolled skin irritation from adhesives; remember that SMBG remains necessary for calibration/validation and during sensor warm‑up.
A 22‑year‑old college student with T1D on MDI reports twice‑weekly nocturnal hypoglycemia and fear of sleeping; after CGM initiation with structured education, hypoglycemia episodes drop from 8 per month to 2, and SMBG is used twice daily to verify sensor accuracy.
Source: Management of Individuals With Diabetes at High Risk for Hypoglycemia: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2023, https://doi.org/10.1210/clinem/dgac596