Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness
What To Discuss With Your Patients and Their Caregivers (2 of 2)
Other things you should discuss with your patients and their caregivers regarding insulin delivery and glucose monitoring strategies in the management of diabetes include:
- The available evidence for the effectiveness of MDI versus CSII for insulin delivery
- The available evidence for the effectiveness of SMBG versus rt-CGM for glucose monitoring
- The patient’s preferences with regard to the mode of insulin delivery and glucose monitoring
- The available evidence for the effectiveness of rt-CGM plus CSII (sensor-augmented pump) versus MDI/SMBG
- The potential risks associated with intensive insulin therapy including hypoglycemic events and weight gain, their impact on quality of life, and strategies for their management
- The potential out-of-pocket costs that the patient might incur with certain insulin delivery and glucose monitoring modalities based on his/her insurance coverage with each option
Abbreviations: CSII = continuous subcutaneous insulin infusion; MDI = multiple daily injections; rt-CGM = real-time continuous glucose monitoring; SMBG = self-monitoring of blood glucose
- Golden SH, Brown T, Yeh HC, et al. Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness. Comparative Effectiveness Review No. 57 (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 290-2007-10061-I). Rockville, MD: Agency for Healthcare Research and Quality; July 2012. AHRQ Publication No. 12-EHC036. Available at www.effectivehealthcare.ahrq.gov/glucose.cfm.
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