Position S tatement on the management of continuous subcutaneous insulin infusion ( CSII ): The Italian Lazio experience: 持续皮下胰岛素输注(CSII)管理的立场申明:意大利拉齐奥经验

This document has been developed by a group of Italian diabetologists with extensive experience in continuous subcutaneous insulin infusion ( CSII ) therapy to provide indications for the clinical management of CSII in diabetic patients (both type 1 and type 2) based on delivery mode operating in I taly. Although the potential benefits of pump therapy in achieving glycemic goals is now accepted, such results cannot be obtained without specific knowledge and skills being conveyed to patients during ad hoc educational training. To ensure that these new technologies reach their full effectiveness, as demonstrated theoretically and clinically, a careful assessment of the overall therapeutic and educational process is required, in both qualitative and quantitative terms. Therefore, to ensure the cost‐effectiveness of insulin pump therapy and to justify reimbursement of therapy costs by the N ational H ealth S ystem in I taly, in this article we present a model for diabetes and healthcare centers to follow that provides for different levels of expertise in the field of CSII therapy. This model will guarantee the provision of excellent care during insulin pump therapies, thus representing the basis for a successful outcome and expansion of this form of insulin treatment in patients with diabetes while also keeping costs under control. 这份文件根据意大利所采用的皮下泵给药模式由意大利糖尿病专家小组制定,他们在持续皮下胰岛素输注(continuous subcutaneous insulin infusion,CSII)治疗方面都具有丰富的经验,对糖尿病患者(包括1型与2型)的CSII临床管理给出了指示。虽然目前已经公认使用泵治疗在血糖达标方面具有潜在的益处,但如果在专门的教育培训期间没有将特定的知识与技能传授给患者,那么就不可能获得这种效果。为了确保使用这些新技术能够获得最佳效果,在理论上与临床上都能证实其有益于血糖达标,需要小心地评估整体治疗与教育过程,既要定性评估又要定量评估。因此,为了确保胰岛素泵治疗的成本效益比以及能够让意大利国家卫生系统为治疗费用报销,在这篇文章中我们提出了一个糖尿病模型,医疗保健中心可以遵循这个指示来执行,它提供了CSII治疗领域内各种不同水平的专业知识。在使用胰岛素泵治疗期间这种模式保证能够提供优质的护理,因此这意味着它是成功结果的基础,这种胰岛素治疗模式在糖尿病患者中扩展后也能使费用处于掌控之中。