Insulin pumps and continuous glucose monitors

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We sought to assess fellows’ knowledge, attitudes, and practices regarding insulin pumps and CGMs using a mixed-methods survey” Marks et al (2019).

Abstract:

BACKGROUND: Recent data demonstrating a lack of improvement in average hemoglobin A1c levels despite the increased use of insulin pumps and continuous glucose monitors (CGMs) suggest that patients are not using these technologies optimally. Suboptimal provider understanding of these devices may be a contributing factor.

METHODS: We sought to assess fellows’ knowledge, attitudes, and practices regarding insulin pumps and CGMs using a mixed-methods survey. We polled 42 pediatric endocrinology fellows and 69 attending physicians in pediatric endocrinology using items on a five-point Likert scale.

RESULTS: Perceived fellow knowledge of insulin pumps and CGMs was only 3.6 ± 1.0 and 3.6 ± 0.9, respectively. Despite consensus about the need for pediatric endocrinologists to understand these technologies, only 14.7% of fellows reported the presence of a formal curriculum about these technologies at their institutions. Potential gaps identified in fellows’ knowledge include general use and troubleshooting, advanced insulin pump features, infusion sets and dermatological complications, systematic approach to data, interpretation and application of CGM data, and keeping pace with technological advances.

CONCLUSIONS: Our data suggest suboptimal fellow knowledge and understanding of insulin pumps and CGMs in pediatric type 1 diabetes management, which is likely attributable to inadequate education in fellowship training programs. The development of formal educational curricula targeting areas of weakness identified in this survey may improve clinician knowledge of these technologies and ultimately impact patient education and care.

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Reference:

Marks, B.E., Wolfsdorf, J.I., Waldman, G., Stafford, D.E. and Garvey, K.C. (2019) Pediatric Endocrinology Trainees’ Education and Knowledge About Insulin Pumps and Continuous Glucose Monitors. Diabetes Technology & Therapeutics. January 25th. .

doi: 10.1089/dia.2018.0331.

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