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Recommends postpartum endocrine care (diabetes management) in addition to usual obstetric care for individuals with preexisting diabetes (including those with pregnancy loss or termination). Triggered by postpartum care planning for patients with diabetes after delivery.

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Guide pump setting adjustments for the MiniMed 780G system based on CareLink data, using Medtronic's 3-step follow-up workflow. Use when a clinician has CareLink data for a 780G patient and wants to know what to change — which setting, by how much, and how to program it. Triggers include: "what do I adjust", "how to fix high TIR", "how to reduce hypos", "adjust ICR/ISF/basal", "SmartGuard settings", "780G pump settings review", or any question about optimising 780G therapy after reviewing a download.

日本語の概要は準備中です。原文の説明を表示しています。

Systematically interpret a Medtronic CareLink or MiniMed 780G Daily Review download in a structured 6-step clinical workflow — covering Time in Range, insulin delivery, day/night patterns, hypo and hyperglycemia root causes, and a prioritised action plan. Trigger when a clinician uploads or shares a CareLink report, MiniMed download, 780G Daily Review, pump download, or asks to review a patient's CGM or insulin pump data.

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Reassesses annually the patient’s use of self-monitoring blood glucose to calibrate the CGM system. Triggered by ‘Yearly calibration practice review’ or ‘Annual check of SMBG calibration adherence’.

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Reassesses annually the patient’s ability to use CGM trend information to adjust insulin doses. Triggered by yearly CGM skills check or annual review of trend-based dosing competence.

日本語の概要は準備中です。原文の説明を表示しています。

Evaluates the patient’s plan for using injected insulin in case of pump failure, including knowledge of basal-bolus dosing. Triggered by phrases such as 'Discuss sick-day plan for pump failure' or 'Review transition to injections if pump stops'.

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Assesses that CGM low- and high-glucose alarm thresholds are individualized to optimize patient benefit and minimize alarm fatigue. Triggered by clinician prompts to 'Review low-glucose alarm thresholds' or 'Ensure alarms are individualized and not excessive'.

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Assesses patient’s understanding of how CGM data (trends, rates of change) differ from discrete SMBG fingerstick values. Triggered when clinicians hear requests to explain lag and trend arrows on CGM or teach the difference between CGM glucose and fingerstick glucose.

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Evaluates patient’s selection of sensor insertion sites and site care to prevent irritation or infection. Triggers include: 'Review CGM site rotation', 'Check sensor site hygiene and adhesion'.

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Recommends real-time CGM with confirmatory bedside POC-BG monitoring for insulin dosing adjustments rather than POC-BG testing alone in adults with insulin-treated diabetes at high risk of hypoglycemia. Consider this approach for patients aged ≥65 years, BMI ≤27 kg/m², total daily insulin dose ≥0.6 units/kg, CKD stage ≥3, or recent hypoglycemia.

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Suggests that adults with type 1 or type 2 diabetes using continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) receive education, training, and ongoing support to achieve and maintain individualized glycemic goals. Trigger phrases include: 'Patient on pump plus CGM, arrange education' and 'Ensure CSII+CGM users get training and support'.

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Suggests continuous subcutaneous insulin infusion (CSII) for adults with type 1 diabetes mellitus who desire increased insulin delivery flexibility or improved treatment satisfaction and are capable of using the device. Clinical triggers include statements such as 'Patient wants more lifestyle flexibility with insulin' or 'Consider pump for improved satisfaction in T1DM'.

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The skill suggests using real-time continuous glucose monitoring (CGM) combined with algorithm-driven insulin pumps (ADIPs) rather than multiple daily injections (MDIs) with self-monitoring of blood glucose (SMBG) three or more times daily for adults and children with type 1 diabetes (T1D) to lower hypoglycemia incidence. Clinical triggers include discussions about insulin pump therapy, CGM use, or reducing hypoglycemia in T1D patients on intensive insulin regimens.

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This skill recommends bilateral adrenalectomy for occult or metastatic ectopic ACTH secretion or as a life-preserving emergency treatment in patients with very severe ACTH‑dependent Cushing’s syndrome who cannot be promptly controlled by medical therapy. It is triggered by life‑threatening complications of uncontrolled hypercortisolism such as infection, pulmonary thromboembolism, cardiovascular catastrophe, or acute psychosis.

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This skill suggests medical therapy to block aberrant hormone receptors for bilateral macronodular adrenal hyperplasia (BMAH) when surgery is not preferred or feasible. Consider this approach in patients with confirmed BMAH and evidence of aberrant hormone receptor expression (e.g., GIP, LH/hCG, serotonin) driving cortisol excess.

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This skill recommends urgent treatment (within 24–72 hours) of hypercortisolism when life‑threatening complications of Cushing's syndrome such as infection, pulmonary thromboembolism, cardiovascular events, or acute psychosis are present. Trigger phrases include sepsis, PE, chest pain with hemodynamic instability, new‑onset psychosis, or delirium in a patient with known or suspected Cushing's.

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This skill recommends re-evaluating the need for treatment of other pituitary hormone deficiencies in the postoperative period following surgical intervention for Cushing's syndrome. It is triggered when assessing a post-op CS patient for ongoing pituitary function, evaluating for hypopituitarism, or checking HPA axis recovery with morning cortisol/ACTH stimulation tests and pituitary MRI within 1–3 months.

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This skill recommends using biochemical tests to screen for hypercortisolism to detect recurrence in patients with ACTH-dependent Cushing's syndrome after surgical remission. It is triggered during postoperative follow-up when the HPA axis has recovered, annually, or sooner if clinical signs of hypercortisolism (e.g., weight gain, hypertension, glucose intolerance) or abnormal late-night salivary cortisol/UFC appear.

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This skill recommends measuring serum sodium several times during the first 5–14 days after transsphenoidal surgery to detect and manage electrolyte disturbances such as postoperative hyponatremia and diabetes insipidus. Use when managing a post-TSS Cushing’s syndrome patient in the early recovery phase; triggers include postoperative day 5–10 hyponatremia, polyuria, fluid intake‑output imbalance, or suspected diabetes insipidus.

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This skill provides a shared decision-making framework for selecting second-line therapies in patients with ACTH-dependent Cushing's syndrome who have persistent hypercortisolism after transsphenoidal surgery or for whom surgery is not feasible. Clinical triggers include "failed TSS", "non-curative pituitary surgery", "persistent UFC elevation post-op", and "surgery contraindicated".

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Recommends steroidogenesis inhibitors as second-line treatment after transsphenoidal surgery (TSS) in Cushing's disease, as primary therapy for occult or metastatic ectopic ACTH syndrome (EAS), and as adjunctive cortisol reduction in adrenocortical carcinoma. Use when evaluating CS patients post‑TSS, with occult/metastatic EAS, or ACC; triggers include “persistent hypercortisolism after TSS,” “occult EAS,” and “adjunctive for ACC.”

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This skill recommends measuring late-night salivary or serum cortisol to screen for Cushing's disease recurrence in patients with eucortisolism after transsphenoidal surgery, including cases where eucortisolism was established by medical treatment prior to surgery. Use when postoperative follow-up shows eucortisolism (normal morning cortisol/UFC) but concern for recurrence exists.

日本語の概要は準備中です。原文の説明を表示しています。

This skill guides postoperative management after Cushing's syndrome surgery by classifying patients into hypocortisolism, hypercortisolism, or eucortisolism based on serum cortisol levels. Use when postoperative cortisol is <5 µg/dL (hypocortisolism), >20 µg/dL (hypercortisolism), or 5-20 µg/dL (eucortisolism) to direct glucocorticoid replacement, further treatment, or monitoring.

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This skill recommends follow-up morning cortisol and/or ACTH stimulation tests or insulin-induced hypoglycemia to assess HPA axis recovery in postoperative Cushing's syndrome patients with at least one intact adrenal gland. Triggers include postoperative remission (morning cortisol <5 µg/dL or UFC <28–56 nmol/d) and the need to evaluate HPA recovery before glucocorticoid discontinuation.

日本語の概要は準備中です。原文の説明を表示しています。