连续血糖监测（CGM）在西班牙的现状

Current Situation Of Continuous Glucose Monitoring (Cgm) In Spain.

 连续血糖监测（CGM）在西班牙的现状。海南医学院附属医院内分泌科王新军

 

F.J. Ampudia-Blasco

Diabetes Reference Unit, Endocrinology & Nutrition Dep., Clinic University Hospital, Valencia, Spain

 

What is the current situation in Spain in relation to CGM utilization? The Working Group of New Technologies of the Spanish Diabetes Society developed in 2009 new guidelines and recommendations for the use of CGM. In this document, a list of clinical and experimental situations in which CGM may have special interest was summarized. In addition, in 2011 the Agency for Health information, Evaluation and Quality of Cataluña in Spain evaluated the available clinical evidence on the efficacy and safety on real-time CGM systems. In this meta-analysis, real-time CGM was considered helpful compared with SMBG in a mixed population of adult or pediatric patients with poor metabolic control.

CGM在西班牙目前的应用现状如何？西班牙糖尿病协会新技术工作组在2009年公布了使用CGM新的指南和建议。本文对CGM的临床和试验状况进行了总结。此外，在2011年，西班牙加泰罗尼亚的卫生信息、评价和质量机构评估了实时CGM系统有效性和安全性的临床证据。在这项荟萃分析中，在所有成人或儿童患者代谢控制较差的患者，与SMBG相比，实时CGM的被认为是有益的。

 

 

In spite of the favorable national documents supporting a more widespread use of CGM, the current situation is that there is still not a national agreement for financial support of CGM technology. Only a limited use of CGM systems is allowed for diagnostic or investigational purposes in some advanced diabetes centers, mainly located in tertiary hospitals. There are some exceptions to this general rule. In some regions as in the Comunidad Valenciana, Cataluña, Extremadura or Castilla-La Mancha, new pumps users of Medtronic devices are occasionally allowed to start with SAP. Additionally, for patients belonging to the MUFACE, i.e. a special group of State official employees, SAP has been also authorized in some cases to start with. In conclusion, SA-pump therapy is still an exception in Spain and is not currently included in the portfolio services of the National Health System.

尽管现有的国家文献支持更广泛的使用CGM，但目前的情况是，仍然没有国家财政支持CGM技术的协议。仅允许在一些三级医院的高级糖尿病中心，以诊断或研究为目的使用CGM。这个规定也有一些例外。在一些地区如：Comunidad Valenciana, Cataluña, Extremadura or Castilla-La Mancha，美敦力公司的新泵设备的用户有时允许开始使用传感器增强型胰岛素泵（SAP）。此外，属于MUFACE的患者，即一个国家正式员工的特殊群体，SAP一直还授权在某些情况下使用。总之，SA泵治疗在西班牙仍然较少，目前不包括在全国卫生系统的综合服务之内。

On behalf of the Working Group of New Technologies of the Spanish Diabetes Society

代表西班牙糖尿病学会新技术工作组