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加拿大糖尿病学会 2018 年临床实践指南:家庭医生照顾 2 型糖尿病患者的关键信息。

Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes.

机构信息

Scientist at Women's College Research Institute in Toronto, Ont, a family physician at Women's College Hospital, Adjunct Scientist in ICES, Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, and Innovation Fellow at the Women's College Hospital Institute for Health System Solutions and Virtual Care.

Medical student at Queen's University in Kingston, Ont.

出版信息

Can Fam Physician. 2019 Jan;65(1):14-24.

Abstract

OBJECTIVE

To summarize the 2018 Diabetes Canada clinical practice guidelines, focusing on high-priority recommendations for FPs managing people who live with type 2 diabetes.

QUALITY OF EVIDENCE

A prioritization process was conducted to focus the efforts of Diabetes Canada's guideline dissemination and implementation efforts. The resulting identified key messages for FPs to consider when managing patients with type 2 diabetes are described. Evidence supporting the guideline recommendations ranges from levels I to IV and grades A to D.

MAIN MESSAGE

Three key messages were identified from the 2018 guidelines as priorities for FPs: discussing opportunities to reduce the risk of diabetes complications, discussing opportunities to ensure safety and prevent hypoglycemia, and discussing progress on self-management goals and addressing barriers. A theme cutting across these key messages was the need to tailor discussions to the needs and preferences of each person. These important guideline recommendations are highlighted, along with information about relevant tools for implementing the recommendations in real-world practice.

CONCLUSION

High-quality diabetes care involves a series of periodic conversations about self-management and about pharmacologic and nonpharmacologic treatments that fit with each patient's goals (ie, shared decision making). Incorporating these conversations into regular practice provides FPs with opportunities to maximize likely benefits of treatments and decrease the risk of harms, to support patients in initiating and sustaining desired lifestyle changes, and to help patients cope with the burdens of diabetes and comorbid conditions.

摘要

目的

总结 2018 年加拿大糖尿病临床实践指南,重点关注家庭医生管理 2 型糖尿病患者的高优先级建议。

证据质量

通过优先排序过程,集中了加拿大糖尿病协会指南传播和实施工作的重点。描述了确定的关键信息,供家庭医生在管理 2 型糖尿病患者时考虑。支持指南建议的证据范围从 I 级到 IV 级,从 A 级到 D 级。

主要信息

从 2018 年指南中确定了三个关键信息,作为家庭医生的优先事项:讨论降低糖尿病并发症风险的机会,讨论确保安全和预防低血糖的机会,以及讨论自我管理目标的进展和解决障碍。贯穿这些关键信息的一个主题是需要根据每个人的需求和偏好调整讨论内容。突出强调了这些重要的指南建议,并提供了有关在实际实践中实施建议的相关工具的信息。

结论

高质量的糖尿病护理涉及一系列关于自我管理以及适合每个患者目标的药物和非药物治疗的定期对话(即共同决策)。将这些对话纳入常规实践为家庭医生提供了机会,可以最大限度地提高治疗效果,降低治疗风险,支持患者启动和维持所需的生活方式改变,并帮助患者应对糖尿病和合并症的负担。

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