以质量求发展，以服务铸品牌

护理学报 ›› 2023, Vol. 30 ›› Issue (21): 39-45.doi: 10.16460/j.issn1008-9969.2023.21.039

• 循证护理 • 上一篇    下一篇

持续血糖监测在糖尿病患者中应用的系统评价再评价

王窈1, 管玉香2, 郑静3, 许娟4, 王超1   

  1. 1.安徽中医药大学 护理学院,安徽 合肥 230012;
    2.安徽中医药大学第一附属医院 护理部,安徽 合肥 230031;
    3.合江县人民医院,四川 泸州 646200;
    4.安庆医药高等专科学校 护理学院,安徽 安庆 246052
  • 收稿日期:2023-05-31 出版日期:2023-11-10 发布日期:2023-12-07
  • 通讯作者: 管玉香（1976-）,女,安徽天长人,本科学历,主任护师,硕士研究生导师。E-mail:897213643@qq.com
  • 作者简介:王窈（1999-）,女,安徽芜湖人,本科学历,硕士研究生在读,护士。
  • 基金资助:
    安徽省卫生健康科研项目（AHWJ2021b068）

Systematic reviews of continuous glucose monitoring in patients with diabetes: an overview

WANG Yao1, GUAN Yu-xiang2, ZHENG Jing3, XU Juan4, WANG Chao1   

  1. 1. School of Nursing, Anhui University of Traditional Chinese Medicine, Hefei 230012, China;
    2. Dept. of Nursing Administration, the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei 230031, China;
    3. Hejiang County People's Hospital, Luzhou 646200, China;
    4. School of Nursing, Anqing Medical College, Anqing 246052, China
  • Received:2023-05-31 Online:2023-11-10 Published:2023-12-07

PDF (PC)

297

赞

摘要： 目的 评价持续血糖监测应用于糖尿病患者相关系统评价的方法学质量和结论的可靠程度。方法 计算机检索中国知网、PubMed等数据库,检索时限为建库至2023年4月1日,收集持续血糖监测应用于糖尿病患者的系统评价。由2名研究人员对文献进行纳入和信息提取,并以多维系统评价评估工具(Assessment of Multiple Systematic Reviews, AMSTAR)和推荐分级的评价、制定与评估标准（Grade of Recommendation,Assessment, Development, and Evaluation, GRADE）对纳入文献的方法学质量和结局指标进行质量评价。结果 共有14篇系统评价被纳入。AMSTAR工具评价结果显示,5篇为高质量文献,9篇为中等质量文献。GRADE系统评价结果显示,44条证据中仅有10条证据等级为中等,低等证据和极低证据分别有20条和14条。结论 持续血糖监测有利于糖尿病患者有关血糖指标的改善,但仍缺乏高质量的证据支撑,纳入研究的方法学研究质量和证据等级不高。未来有待于开展更多的高质量研究证实结论的可靠性。

关键词: 持续血糖监测, 糖尿病, 系统评价再评价, GRADE

Abstract: Objective To evaluate the methodological quality and reliability of the systematic reviews on continuous blood glucose monitoring in diabetic patients. Methods We collected systematic reviews of continuous glucose monitoring in patients with diabetes from China National Knowledge Network, PubMed and other databases by computer. The retrieval period was from the inception to April 1, 2023. Two researchers extracted the information and evaluated the methodological quality and outcome indicators of the included literature by using Assessment of Multiple Systematic Reviews (AMSTAR) and Grade of Recommendation, Assessment, Development, and Evaluation(GRADE). Results Fourteen systematic reviews were collected. AMSTAR showed that 5 pieces of literature were of high quality and 9 of medium quality. The evaluation with GRADE system showed that only 10 of the 44 pieces of evidences were with medium grade, while 20 with low grade and 14 with extremely low grade. Conclusion Continuous blood glucose monitoring is conducive to the improvement of relevant blood glucose indicators in diabetic patients, but there is still a lack of high-quality evidence support, and the quality of methodological research and evidence quality of included studies is not high. In the future, more high-quality studies are needed to confirm the reliability of the conclusions.

Key words: continuous blood glucose monitoring, diabetes mellitus, overview of systematic review, GRADE

中图分类号: 

  • R473.58
[1] Harreiter J, Roden M.Diabetes mellitus - definition, klassifikation, diagnose, screening und prävention (Update 2019)[J]. Wien Klin Wochenschr, 2019, 131(1_suppl): 6-15. DOI:10.1007/s00508-019-1450-4.
[2] Sun H, Saeedi P, Karuranga S, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for2021 and projections for 2045[J]. Diabetes Res Clin Pract, 2022(183): 109119. DOI: 10.1016/j.diabres.
[3] Li Y, Teng D, Shi X, et al. Prevalence of diabetes recorded in mainland China using2018 diagnostic criteria from the American Diabetes Association: national cross sectional study[J]. BMJ, 2020(369): m997. DOI: 10.1136/bmj.m997.
[4] 卢舒颖,刘宁,廉民学. 糖尿病患者急性卒中后血糖监测及管理的最佳证据总结[J]. 护理学报,2021,28(15):42-47. DOI:10.16460/j.issn1008-9969.2021.15.042.
[5] Charleer S, Mathieu C, Nobels F, et al.Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life:a real-world study[J]. J Clin Endocr Metab, 2018, 103(3): 1224-1232. DOI: 10.1210/jc.2017-02498.
[6] 卜凡莉,梁枫,王珂,等. 对ICU行肠内营养支持患者胃残留量监测相关系统评价的再评价[J]. 护理学报,2019,26(5):25-29. DOI: 10.16460/j.issn1008-9969.2019.05.025.
[7] 张金苹,陈晓平.《2022年美国糖尿病学会糖尿病医学诊疗标准》解读[J]. 临床内科杂志,2022,39(5):293-298. DOI:10.3969/j.issn.1001-9057.2022.05.002.
[8] Shea BJ, Grimshaw JM, Wells GA, et al.Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews[J]. BMC Med Res Methodol, 2007, 15(7):10. DOI:10.1186/1471-2288-7-10.
[9] 曾宪涛,冷卫东,李胜,等. 如何正确理解及使用GRADE系统[J].中国循证医学杂志,2011,11(9):985-990. DOI: 10.3969/j.issn.1672-2531.2011.09.002.
[10] 魏美林,王倩倩,韩峻峰,等. CGM与SMBG改善1型糖尿病患者血糖控制及减少低血糖事件发生的Meta分析[J]. 同济大学学报(医学版),2015,36(5):79-84. DOI: 10.16118/j.1008-0392.2015.05.017.
[11] Janapala RN, Jayaraj JS, Fathima N, et al.Continuous glucose monitoring versus self-monitoring of blood glucose in type 2 diabetes mellitus: a systematic review with Meta-analysis[J]. Cureus, 2019, 11(9): e5634. DOI: 10.7759/cureus.5634.
[12] Teo E, Hassan N, Tam W, et al.Effectiveness of continuous glucose monitoring in maintaining glycaemic control among people with type 1 diabetes mellitus: a systematic review of randomised controlled trials and Meta-analysis[J]. Diabetologia, 2022, 65(4): 604-619.DOI: 10.1007/s00125-021-05648-4.
[13] Wojciechowski P, Ryś P, Lipowska A, et al.Efficacy and safety comparison of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes: systematicreview and Meta-analysis[J]. Pol Arch Med Wewn, 2011, 121(10): 333-343.
[14] Ida S, Kaneko R, Murata K.Utility of real-time and retrospective continuous glucose monitoring in patients with type 2 diabetes mellitus: a Meta-analysis of randomized controlled trials[J]. J Diabetes Res, 2019(2019): 4684815. DOI: 10.1155/2019/4684815.
[15] Kłak A, Mańczak M, Owoc J, et al.Impact of continuous glucose monitoring on improving emotional well-being among adults with type 1 diabetes mellitus: a systematic review and Meta-analysis[J]. Pol Arch Intern Med, 2021, 131(9): 808-818. DOI: 10.20452/pamw.16047.
[16] Elbalshy M, Haszard J, Smith H, et al.Effect of divergent continuous glucose monitoring technologies on glycaemic control in type 1 diabetes mellitus: a systematic review and Meta-analysis of randomised controlled trials[J]. Diabet Med, 2022, 39(8): e14854. DOI: 10.1111/dme.14854.
[17] Park C, Le QA.The Effectiveness of continuous glucose monitoring in patients with type 2 diabetes: a systematic review of literature and Meta-analysis[J]. Diabetes Technol Ther, 2018, 20(9):613-621.DOI:10.1089/dia.2018.0177.
[18] Golicki DT, Golicka D, Groele L, et al.Continuous glucose monitoring system in children with type 1 diabetes mellitus: a systematic review and Meta-analysis[J]. Diabetologia,2008, 51(2): 233-240. DOI: 10.1007/s00125-007-0884-9.
[19] Gandhi GY, Kovalaske M, Kudva Y, et al.Efficacy of continuous glucose monitoring in improving glycemic control and reducing hypoglycemia: a systematic review and Meta-analysis of randomized trials[J]. J Diabetes Sci Technol, 2011, 5(4): 952-965. DOI: 10.1177/193229681100500419.
[20] Szypowska A, Ramotowska A, Dzygalo K, et al.Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and Meta-analysis of randomized trials[J]. Eur J Endocrinol,2012,166(4):567-574.DOI:10.1530/EJE-11-0642.
[21] Poolsup N, Suksomboon N, Kyaw AM.Systematic review and Meta-analysis of the effectiveness of continuous glucose monitoring (CGM) on glucose control in diabetes[J]. Diabetol Metab Syndr,2013(5):39.DOI:10.1186/1758-5996-5-39.
[22] Di Molfetta S, Caruso I, Cignarelli A, et al.Professional continuous glucose monitoring in patients with diabetes mellitus: a systematic review and Meta-analysis[J]. Diabetes Obes Metab, 2023, 25(5): 1301-1310. DOI: 10.1111/dom.14981.
[23] Wang Y, Zou C, Na H, et al.Effect of different glucose monitoring methods on bold glucose control: a systematic review and Meta-analysis[J]. Comput Math Methods Med, 2022(2022): 2851572. DOI: 10.1155/2022/2851572.
[24] 郑辛甜,何小军,邵菊芳,等.《中华急诊医学杂志》发表的系统评价/Meta分析的质量评价[J].中华急诊医学杂志,2016,25(9):1216-1218.DOI:10.3760/cma.j.issn.1671-0282.2016.09.029.
[25] Charleer S, Mathieu C, Nobels F, et al.Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life: a real-world study[J]. J Clin Endocr Metab,2018,103(3):1224-1232.DOI:10.1210/jc.2017-02498.
[26] Bailey T, Bode BW, Christiansen MP, et al.The performance and usability of a factory-calibrated flash glucose monitoring system[J]. Diabetes Technol Ther, 2015, 17(11):787-794. DOI: 10.1089/dia.2014.0378.
[27] Parums DV.Editorial: review articles, systematic reviews, metaanalysis, and the updated preferred reporting items for systematic reviews and Meta-analyses(PRISMA)2020 guidelines[J]. Med Sci Monit, 2021(27):e934475. DOI:10.12659/MSM.934475.
[1] 唐鸿霞, 张铭鹪, 陈梦杰, 钟梦婷, 刘漫, 胡凤慧, 王勤, 王晓夏, 孔莱熙, 郭茂婷, 熊真真. 糖尿病数字化管理APP对2型糖尿病患者血糖控制的效果研究[J]. 护理学报, 2023, 30(7): 71-74.
[2] 张海燕, 于卫华, 张利, 任影, 郑俊俊. 2型糖尿病老年患者生活空间移动性受限风险预测模型研究[J]. 护理学报, 2023, 30(22): 13-19.
[3] 朱明月, 史纪元, 李峥. 计算机化认知训练对认知功能障碍患者干预效果的系统评价再评价[J]. 护理学报, 2023, 30(21): 46-53.
[4] 牛雨楠, 晋溶辰, 何娅娜, 黄金. 糖尿病足就诊延迟障碍因素及时间界定的研究进展[J]. 护理学报, 2023, 30(20): 16-18.
[5] 周贵玲, 徐蓉, 边旭娜, 郑维. 中青年2型糖尿病患者健康素养量表的研制及信效度检验[J]. 护理学报, 2023, 30(14): 73-78.
[6] 张欣, 尹卫, 刘巧艳, 金华怡, 祖后娟. 妊娠期糖尿病患者血糖管理决策体验的纵向质性研究[J]. 护理学报, 2023, 30(12): 22-26.
[7] 王锐, 李智, 杨芹, 王春立, 李凤婷, 王旭梅. 1型糖尿病患儿居家低血糖识别及处理最佳证据总结[J]. 护理学报, 2022, 29(7): 50-56.
[8] 阚吟诗, 刘林, 李翔宁, 刘洪园, 毕雅昕, 张露, 张瑜. 糖尿病患者体力活动波动性的研究进展[J]. 护理学报, 2022, 29(6): 32-36.
[9] 王雪, 崔仁善, 聂恒卓, 刘海平. 社区老年2型糖尿病患者基于OTO模式健康管理的效果观察[J]. 护理学报, 2022, 29(19): 65-69.
[10] 王柯, 吴瑾, 黄红玉, 李心仪, 周明明, 吴晓娜. 糖尿病住院患儿规范化医学营养管理的品管圈实践[J]. 护理学报, 2022, 29(1): 13-16.
[11] 王琦, 李领侠, 和巾杰, 郑华东, 米晓芬, 胡艳粉. 医护人员低血糖症知信行问卷的编制及信效度检验[J]. 护理学报, 2021, 28(9): 9-13.
[12] 严佳丽, 裘慧颖, 贾芸, 刘倩静, 富晶晶, 金云秋. 模拟体验并发症健康教育在中青年初发2型糖尿病患者中的应用[J]. 护理学报, 2021, 28(5): 75-78.
[13] 施赵维, 张扬, 官常荣, 郑晓佳, 陈敏华. 2型糖尿病患者营养干预联合家庭主要成员烹饪实践教育[J]. 护理学报, 2021, 28(4): 73-76.
[14] 赵露, 顾培培, 李玉雪, 郑丽萍, 李俊玲. 糖尿病足截肢患者应对方式在伤残接受度与生活质量间的中介效应[J]. 护理学报, 2021, 28(23): 11-16.
[15] 李雪嘉, 杨开庆. 2型糖尿病患者酮症酸中毒风险预测模型的构建与验证[J]. 护理学报, 2021, 28(22): 12-17.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!