以质量求发展，以服务铸品牌
2025年5月9日 星期五

护理学报 ›› 2024, Vol. 31 ›› Issue (22): 41-47.doi: 10.16460/j.issn1008-9969.2024.22.041

• 循证护理 • 上一篇    下一篇

成人糖尿病患者低血糖管理的指南质量评价及内容分析

陈丽燕a, 任俊b, 董辉b, 陈慕莹c, 罗伟香d   

  1. 深圳市人民医院 暨南大学第二临床医学院 南方科技大学第一附属医院 a.内分泌科; b.急诊科; c.老年病科; d.护理部,广东 深圳 518020
  • 收稿日期:2024-04-11 出版日期:2024-11-25 发布日期:2024-12-04
  • 通讯作者: 罗伟香（1968-）,女,湖南邵东人,教授,硕士研究生导师,护理部主任。E-mail：luoweixiang688@126.com
  • 作者简介:陈丽燕（1996-）,女,江西新余人,硕士学历,主管护师。
  • 基金资助:
    2022年深圳市人民医院护理中青年科研基金院内立项课题（SYHL2022——N0002）

Quality evaluation and content analysis of guidelines for hypoglycemia management in adults with diabetes

CHEN Li-yana, RENG Junb, DONG Huib, CHEN Mu-yingc, LU Wei-xiangd   

  1. a. Dept. of Endocrinology; b. Dept. of Emergency; c. Dept. of Geriatrics; d. Dept. of Nursing Administration, Shenzhen People's Hospital, the Second Clinical Medical College, Jinan University, the First Affiliated Hospital Southern University of Science and Technology, Shenzhen 518020, China
  • Received:2024-04-11 Online:2024-11-25 Published:2024-12-04

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摘要： 目的 评价成人糖尿病患者低血糖管理相关指南,为临床工作实践提供参考意见。方法 检索国内外数据库、指南和相关学会网站。2名研究者独立提取资料,3名研究者运用临床指南研究与评价工具Ⅱ（Appraisal of Guidelines for Research & Evaluation Ⅱ,AGREE Ⅱ）对临床实践指南进行质量评价并汇总分析推荐意见。结果 共纳入17部指南,其中10部临床实践指南和7部专家共识,指南总体质量评价较高。共提取低血糖分级、意识清醒和意识不清或无意识患者低血糖处理、血糖恢复后处理、肠内营养者和佩戴胰岛素泵者低血糖处理、低血糖预防7个方面意见。结论 纳入的指南总体质量较高,可以为我国糖尿病成人低血糖管理的临床实践提供循证证据支持,但是将国外指南应用于我国临床情境需经过严格的本土化过程。

关键词: 糖尿病, 低血糖, 指南, 质量评价, 内容分析

Abstract: Objective To evaluate the guidelines related to hypoglycemia management in adults with diabetes and provide reference for clinical practice. Methods Domestic and international databases, guidelines and websites of relevant societies were searched. Two researchers independently extracted data, and three researchers used Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) to evaluate the quality of clinical practice guidelines and summarize and analyze the recommended opinions. Results A total of 17 guidelines were included, including 10 clinical practice guidelines and 7 expert consensuses. The overall quality evaluation of the guidelines was relatively high. Seven opinions were extracted regarding the classification of hypoglycemia, the management of hypoglycemia in conscious, unconscious or unresponsive patients, the management of hypoglycemia after blood glucose recovery, the management of hypoglycemia in enteral nutrition recipients and insulin pump wearers and the prevention of hypoglycemia. Conclusion The included guidelines are generally of high quality, which can provide evidence-based support for the clinical practice of hypoglycemia management for adults with diabetes in China. However, a strict localization of foreign guidelines is required before being applied to the clinical environment in China.

Key words: diabetes, hypoglycemia, guideline, quality evaluation, content analysis

中图分类号: 

  • R473.58
[1] The International Diabetes Federation.IDF diabetes atlas2021[EB/OL].[2024-07-11].https://diabetesatlas.org/.
[2] Blonde L, Umpierrez GE, Reddy SS, et al.American Association of Clinical Endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan-2022 update[J]. Endocr Pract,2022,28(10):923-1049. DOI: 10.1016/j.eprac.2022.08.002.
[3] Savard V, Gingras V, Leroux C, et al.Treatment of hypoglycemia in adult patients with type 1 diabetes: an observational study[J]. Can J Diabetes,2016,40(4):318-323.DOI: 10.1016/j.jcjd.2016.05.008.
[4] 程湘玮,张纹,王培红,等.新生儿血糖管理临床实践指南质量评价及内容分析[J].中国护理管理,2020,20(10):1551-1556.DOI:10.3969/j.issn.1672-1756.2020.10.026.
[5] Villani M, de Courten B, Zoungas S. Emergency treatment of hypoglycaemia: a guideline and evidence review[J]. Diabet Med,2017,34(9):1205-1211. DOI:10.1111/dme.13379.
[6] Luo K, Tang J, Zhang M, et al.Systematic review of guidelines on neonatal hypoglycemia[J]. Clin Endocrinol (Oxf),2024,100(1):36-49. DOI:10.1111/cen.14995.
[7] Christiaens A, Henrard S, Zerah L, et al.Individualisation of glycaemic management in older people with type 2 diabetes: a systematic review of clinical practice guidelines recommendations[J]. Age Ageing,2021,50(6):1935-1942. DOI:10.1093/ageing/afab157.
[8] 陈耀龙,罗旭飞,王吉耀,等.如何区分临床实践指南与专家共识[J].协和医学杂志, 2019, 10(4):403-408.DOI:10.3969/j.issn.1674-9081.2019.04.018.
[9] Brouwers MC, Kerkvliet K, Spithoff K, et al.The AGREE reporting checklist: a tool to improve reporting of clinical practice guidelines[J].BMJ,2016,352(8):i1152. DOI:10.1136/bmj 11152.
[10] McArthur A, Klugarova J, Yan H, et al. Innovations in the systematic review of text and opinion[J]. Int J Evid Based Healthc,2015,13(3):188-195.DOI:10.1097/XEB.0000000000000060.
[11] 崔立军,鲍勇,陈昕,等.中国康复临床实践指南的质量评价[J].中国循证医学杂志,2019,19(6):723-728.DOI:10.7507/1672-2531.201806079.
[12] 褚玲玲,陈萍,冯丹,等.肿瘤相关静脉血栓栓塞症防治指南的质量评价及内容分析[J].护理学报,2022,29(16):43-48.DOI:10.16460/j.issn1008-9969.2022.16.043.
[13] Pleil JD, Sobus JR.Estimating lifetime risk from spot biomarker data and intraclass correlation coefficients (ICC)[J]. J Toxicol Environ Health A, 2013, 76(12):747-766. DOI: 10.1080/15287394.2013.821394.
[14] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志, 2015, 30(11):964-967. DOI:10.16821/j. cnki.hsjx.2015.11.002.
[15] American Diabetes Association Professional Practice Committee. 6. Glycemic goals and hypoglycemia:standards of care in diabetes-2024[J]. Diabetes Care,2024,47(Suppl 1):S111-S125. DOI:10.2337/dc24-S006.
[16] McCall AL, Lieb DC, Gianchandani R, et al. Management of individuals with diabetes at high risk for hypoglycemia: an Endocrine Society clinical practice guideline[J]. J Clin Endocrinol Metab,2023,108(3):529-562.DOI:10.1210/clinem/dgac596.
[17] Diabetes Canada Clinical Practice Guidelines Expert Working Group.hypoglycemia in adults[J]. Can J Diabetes,2023,47(7):548-559. DOI:10.1016/j.jcjd.2023.08.003.
[18] Polskie Towarzystwo Diabetologiczne.2023 Guidelines on the management of patients with diabetes[R/OL].(2023-01-01)[2024-07-11].https://www.currenttopicsindiabetes.com/pdf-160061-89991?filename=2023%20Guidelines%20on%20the.pdf.DOI: https://doi.org/10.5114/ctd/160061.
[19] Blonde L, Umpierrez GE, Reddy SS, et al.American Association of Clinical Endocrinology clinical practice guideline: developing a diabetes mellitus comprehensive care plan-2022 update[J]. Endocr Pract,2022,28(10):923-1049. DOI: 10.1016/j.eprac.2022.08.002.
[20] 《中国老年型糖尿病防治临床指南》编写组.中国老年2型糖尿病防治临床指南(2022年版)[J].中国糖尿病杂志,2022, 30(1):2-51.DOI:10.3969/j.issn.1006-6187.2022.01.002.
[21] 中华医学会糖尿病学分会,国家基层糖尿病防治管理办公室.国家基层糖尿病防治管理指南(2022)[J].中华内科杂志,2022,61(3):249-262. DOI:10.3760/cma.j.cn112138-20220120-000063.
[22] 中华医学会糖尿病学分会,中国医师协会内分泌代谢科医师分会,中华医学会内分泌学分会,等.中国1型糖尿病诊治指南(2021版)[J].中华糖尿病杂志,2022,14(11):1143-1250.DOI:10.3760/cma.j.cn115791-20220916-00474.
[23] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021, 13(4):315-409.DOI:10.3760/cma.j.cn115791-20210221-00095.
[24] Araki E, Goto A, Kondo T, et al.Japanese clinical practice guideline for diabetes 2019[J]. J Diabetes Investig, 2020,11(4):1020-1076. DOI:10.1111/jdi.13306
[25] Joint British Diabetes Societies (JBDS) for Inpatient Care Group.Glycaemic management during enteral feeding for people with diabetes in hospital[R/OL].(2023-01-01)[2024-07-11].https://abcd.care/sites/default/files/resources/JBDS_05_Enteral_Feeding%20_Guideline_April_2024.pdf.
[26] Joint British Diabetes Societies (JBDS) for Inpatient Care Group.Using technology to support diabetes care in hospital[R/OL].(2023-02-01)[2024-07-11].https://diabetes-resources-production.s3.eu-west-1.amazonaws.com/resources-s3/public/2024-03/JBDS%2020%20Technology%20Guideline.pdf.
[27] Joint British Diabetes Societies (JBDS) for Inpatient Care Group.Diabetes at the Front Door[R/OL].(2023-05-01)[2024-07-11].https://abcd.care/sites/default/files/site_uploads/JBDS_Guidelines_Current/JBDS_16_Diabetes_at_the_Front
_Door_Guideline_with_QR_code_May_2023.pdf.
[28] Joint British Diabetes Societies (JBDS) for Inpatient Care Group.The hospital management of hypoglycaemia in adults with diabetes mellitus[R/OL].(2023-01-01)[2024-07-11].abcd.care/sites/default/files/site_uploads/JBDS_Guidelines_Current/JBDS_01_Hypo_Guideline_with_QR_code_January29_2023.pdf.
[29] Joint British Diabetes Societies (JBDS) for Inpatient Care Group.Guideline for perioperative care for people with diabetes mellitus undergoing elective and emergency surgery[R/OL].(2023-01-01)[2024-07-11].https://abcd.care/sites/default/files/site_uploads/JBDS_Guidelines_Current/JBDS_03_CPOC_Diabetes_Surgery_Guideline_Updated_2022.pdf.
[30] Roberts AW,Penfold S,Joint British Diabetes Societies (JBDS) for inpatient care croup. Glycaemic management during the inpatient enteral feeding of people with stroke and diabetes[J]. Diabet Med,2018,35(8):1027-1036. DOI:10.1111/dme.13678.
[31] Joint British Diabetes Societies (JBDS) for Inpatient Care Group.A good inpatient diabetes service[R/OL].(2020-07-01)[2024-07-11]. https://abcd.care/sites/default/files/site_uploads/JBDS_Guidelines_Current/JBDS_14_A_Good_Inpatient_Service_Updated_060720.pdf.
[32] Muñoz-Manrique C, Ancira-Moreno M, Burrola-Méndez S.Quality appraisal of nutritional guidelines to prevent,diagnose,and treat malnutrition in all its forms during pregnancy[J].Nutrients,2022,14(21):4579.DOI:10.3390/nu14214579.[33] 倪乐凤,刘林,沈春华,等.输血护理时限管理相关指南的质量评价及内容分析[J].护理学报,2024,31(7):51-56.DOI10.16460/j.issn1008-9969.2024.07.051.
[34] 卜丝丝,李玉红,丁礼雪,等.妊娠期女性身体活动指南的质量评价及内容分析[J].护理学报,2023,30(4):49-54.DOI:10.16460/j.issn1008-9969.2023.04.049.
[35] Chen Y, Wang C, Shang H, et al.Clinical practice guidelines in China[J]. BMJ,2018,360(5):j5158. DOI:10.1136/bmj.j5158.
[36] Diabetes Canada Clinical Practice Guidelines Expert Committee. Hypoglycemia[J]. Can J Diabetes,2018,42(Suppl 1) :S104-S108. DOI:10.1016/j.jcjd.2017.10.010.
[37] Phillip M, Kowalski A, Battelino T.Type 1 diabetes: from the dream of automated insulin delivery to a fully artificial pancreas[J]. Nat Med, 2024,30(5):1232-1234. DOI:10.1038/d41591-024-00013-5.
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