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美国临床内分泌学会临床实践指南:制定糖尿病综合护理计划-2022 更新版。

American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.

机构信息

Ochsner Health, New Orleans, Louisiana.

Emory University, Atlanta, Georgia.

出版信息

Endocr Pract. 2022 Oct;28(10):923-1049. doi: 10.1016/j.eprac.2022.08.002. Epub 2022 Aug 11.

Abstract

OBJECTIVE

The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers.

METHODS

The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development.

RESULTS

This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes.

CONCLUSIONS

This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.

摘要

目的

本临床实践指南的目的是为临床医生、糖尿病护理团队、其他医疗保健专业人员和利益相关者以及糖尿病患者及其护理人员提供更新和新的循证建议,以全面护理糖尿病患者。

方法

美国临床内分泌医师学会选择了一个由医学专家和工作人员组成的工作组,他们更新和评估了 2015 年版该指南中的临床问题和建议,并对 2015 年 1 月 1 日至 2022 年 5 月 15 日期间发表的相关科学论文进行了文献检索。从文献检索结果中选择的研究构成了更新 2015 年建议以及根据临床证据、当前实践、专业知识和共识审查制定新建议的证据基础,这符合美国临床内分泌医师学会制定指南的既定方案。

结果

本指南包括 170 项针对糖尿病患者全面护理的更新和新循证临床实践建议。建议分为四个部分:(1)筛查、诊断、血糖目标和血糖监测;(2)合并症和并发症,包括肥胖症以及生活方式、营养和减重手术、高血压、血脂异常、视网膜病变、神经病变、糖尿病肾病和心血管疾病的管理;(3)糖尿病前期、抗高血糖药物治疗和血糖目标的 2 型糖尿病、胰岛素治疗的 1 型糖尿病、住院患者以及妊娠糖尿病妇女的管理;(4)关于糖尿病和不孕、营养补充剂、继发性糖尿病、健康的社会决定因素和虚拟护理的新主题,以及关于癌症风险、儿科护理计划的非药物成分、抑郁、教育和团队方法、职业风险、睡眠医学的作用以及糖尿病患者疫苗接种的更新建议。

结论

本更新的临床实践指南提供了循证建议,以协助以患者为中心、以团队为基础的临床决策,从而改善糖尿病患者的护理。

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