护理学报 ›› 2020, Vol. 27 ›› Issue (13): 27-32.doi: 10.16460/j.issn1008-9969.2020.13.027
刘巧艳1, 步红兵1, 尹卫1, 朱丽群1, 黄贤凤1, 沈支佳2, 朱冬梅2, 许步慧1, 齐银银1, 孙赞赞1, 杨玲1
LIU Qiao-yan1, BU Hong-bing1, YIN Wei1, ZHU Li-qun1, HUANG Xian-feng1, SHEN Zhi-jia2, ZHU Dong-mei2, XU Bu-hui1, QI Yin-yin1, SUN Zan-zan1, YANG Ling1
摘要: 目的 遴选并获取住院老年2型糖尿病患者低血糖管理的最佳证据,为医护人员、管理者、患者及家属临床实践提供参考。方法 用PIPOST构建循证问题,系统检索BMJ Best Practice、Up To Date、JBI、RNAO等数据库关于住院老年2型糖尿病患者低血糖管理的所有证据,由2名研究者对纳入文献的质量进行独立评价,证据提取、综合。结果 纳入21篇文献,临床决策1篇、证据总结9篇、指南8篇、1篇系统评价及2篇专家共识,形成33条最佳证据,包括评估、饮食预防、运动预防、药物预防、监测预防、低血糖教育、急救设备、应急处理及后续处理9个维度。结论 本研究总结目前关于住院老年2型糖尿病患者低血糖评估、预防与处理的最佳证据,能够为临床医护人员提供科学指导,满足不同状态老年糖尿病患者低血糖的预防与处理。
中图分类号:
[1] 中华人民共和国国家统计局.中华人民共和国2017年国民经济和社会发展统计公报[R/OL]. (2018-02-08)[2018-04-28]. http://www. stats. gov. cn/ tjsj/zxfb/201802/t20180228-1585631.html. [2] LeRoith D, Biessels GJ, Braithwaite SS, et al.Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline[J]. J Clin Endocrinol Metab,2019,104(5):1520-1574.DOI:10. 1210/jc.2019-00198. [3] Barrot-de la Puente J, Mata-Cases M,Franch-Nadal J,et al.Older Type 2 Diabetic Patients Are More Likely To Achieve Glycaemic and Cardiovascular Risk Factors Targets Than Younger Patients: Analysis of a Primary Care Database[J].Int J Clin Pract, 2015, 69(12):1486-1495.DOI:10.1111/ijcp.12741. [4] 胡雁,郝玉芳.循证护理学[M].北京:人民卫生出版社,2018. [5] 杨中善,许妮娜,詹昱新,等.住院患者规范化身体约束管理最佳证据总结[J].护理学报,2019, 26(4):31-36.DOI:10.16460/j.issn1008-9969.2019.04. 031. [6] 谢利民,王文岳.《临床指南研究与评价系统II》简介[J].中西医结合学报,2012,10(2):160-165. [7] The Joanna Briggs Institute. Critical Appraisal Checklist for Systematic Reviews and Research Syntheses[EB/OL].[2018-11-22].http://joannabriggs.org/research/critical-appraisal tools.html. [8] The Joanna Briggs Institute. Critical Appraisal Checklist for Text and Opinion[EB/OL].[2018-11-22].http://joannabriggs.org/research/critical-appraisal-tools.html. [9] 王青春,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. [10] 何文斌,廖尧,尹熙,等.心脏瓣膜置换术后患者Ⅰ期心脏康复的最佳证据总结[J].护理学报,2019,26(18):32-36.DOI:10.16460/j.issn1008-9969.2019.18. [11] Cryer PE. Hypoglycemia in Adults with Diabetes Mellitus[EB/OL]. (2019-01-03)[2019-04-30].https://www.uptodate.com/contents/hypoglycemia-in-adults-with-diabetes-mellitus?search=Hypoglycemia%20in%20adults%20with%20diabetes%20mellitus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1. [12] B.Pharm L. Diabetes(Type 2): Blood GlucoseManagement[EB/OL].(2018-03-16)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [13] Porritt K.Type 2 Diabetes and Ramadan:Non-pharmacological Interventions for the Prevention of Hypoglycemia[EB/OL].(2018-03-22)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [14] Porritt K. Type 2 Diabetes and Ramadan: Pharmacological Interventions for the Prevention of Hypoglycemia[EB/OL].(2018-03-22)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [15] Koh G. Exercise in Diabetic Patients: Hypoglycemia[EB/OL].(2018-02-23)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [16] Nguyen P. Blood Glucose Levels: Self-Monitoring[EB/OL].(2018-11-08)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [17] Fong E. Hypoglycemia in Diabetes: Management[EB/OL].(2017-12-10)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [18] Li Y. Diabetes Mellitus(Type 2):ExercisePrescription[EB/OL].(2017-08-18)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [19] Li Y. Diabetes (Type 2): Dietary Management [EB/OL].(2017-08-14)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [20] The Joanna Briggs Institute. Hypoglycemia Management: Aged Care Setting[EB/OL].(2016-03-29)[2019-04-30].http://ovidsp.tx.ovid.corrdsp-3.30.0b/ovidweb.egi=S.sh.40%7c2%7c1. [21] Polish Diabetes Association. 2019 Guidelines on the Management of Diabetic Patients[EB/OL].(2019-01-20)[2019-04-30].http://guide.medlive.cn/guideline/17365. [22] American Diabetes Association.Introduction: Standards of Medical Care in Diabetes-2019[J]. J Diabetes Care,2019,42(1):S139-S147.DOI:10.2337/dc19-S012. [23] Amiel S,Crowley C,Dhatariya K,et al.The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus,[EB/OL].(2018-04-01)[2019-04-30].http://guide.medlive.cn/guideline/15816. [24] Canadian Diabetes Association. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada[EB/OL].(2018-04-30)[2019-04-30].http://guide.medlive.cn/guideline/16003. [25] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.DOI:10.3760/cma.j.issn.1674-5809.2018.01.003. [26] Moreno G, Mangione CM, Kimbro L,et al.Guidelines Abstracted from the American Geriatrics Society Guidelines for Improving the Care of Older Adults with Diabetes Mellitus: 2013 Update[J].J Am Geriatr Soc,2013,61(11):2020-2026.DOI:10.1111/jgs.12514. [27] Sinclair AJ, Paolisso G, Castro M, et al.European Diabetes Working Party for Older People 2011 Clinical Guidelines for Type 2 Diabetes Mellitus Executive Summary[J]. Diabetes Metab,2011, 37(3):S27-38.DOI:10.1016/S1262-3636(11)70962-4. [28] Thomas D.Low Glycaemic Index, or Low Glycaemic Load, Diets for Diabetes Mellitus[J].Cochrane Database Syst Rev,2009(1):D6296.DOI:10.1002/14651858.CD006296.pub2. [29] Seaquist ER, Anderson J,Childs B,et al.Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and the Endocrine Society[J]. Diabetes care,2013,36(5):1384-1395.DOI:10. 2337/ dc12-2480. [30] Kirkman MS,Briscoe VJ, Clark N, et al.Diabetes in Older Adults: A Consensus Report[J]. J Am Geriatr Soc,2012,60(12):2342-2356. DOI:10.1111/jgs.12035. [31] Carlson JN, Schunder-Tatzber S,Neilson CJ.Dietary Sugars Versus Glucose Tablets for First-aid Treatment of Symptomatic Hypoglycaemia in Awake Patients with Diabetes: A Systematic Review and Meta-analysis[J]. Emerg Med J,2017,34(2):100-106.DOI:10.1136/ emermed-2015-205637. [32] Seaquist ER, Anderson J,Childs B,et al.Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and the Endocrine Society[J].J Clin Endocrinol Metab,2013,98(5):1845-1859.DOI:10.1210/jc.2012-4127. [33] International Hypoglycaemia Study Group. Minimizing Hypoglycemia in Diabetes[J].Diabetes Care,2015,38(8):1583-1591.DOI:10.2337/dc15-0279. [34] Sanz-Paris A, Álvarez Hernández J,Ballesteros-Pomar MD,et al.Evidence-based Recommendations and Expert Consensus on Enteral Nutrition in the Adult Patient with Diabetes Mellitus or Hyperglycemia[J]. Nutrition,2017(41):58-67.DOI:10.1016/j.nut.2017.02.014. [35] Haak T, Hanaire H, Ajjan R,et al.Flash Glucose-Sensing Technology as a Replacement for Blood Glucose Monitoring for the Management of Insulin-treated Type 2 Diabetes: A Multicenter, Open-label Randomized Controlled Trial[J].J Diabetes Ther,2017,8(1):55-73.DOI:10.1007/s13300 -016-0223-6. [36] Wood SP. Is D50 too much of a Good Thing? A Reappraisal of the Safety of 50% Dextrose Administration in Patients with Hypoglycemia[J]. J JEMS,2007,32(3):103-106;108;110. |
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