Center for Clinical Best Practices, Clinical and Translational Research Incubator (CITRIC), Aga Khan University, Karachi, 74800, Pakistan.
Medical College, Aga Khan University, Karachi, 74800, Pakistan.
Diabetes Metab Syndr. 2024 Jul;18(7):103094. doi: 10.1016/j.dsx.2024.103094. Epub 2024 Jul 30.
Clinical practice guidelines (CPGs) are a helpful tool for the evidence-based management of Type 2 Diabetes Mellitus (T2D). The aim of this systematic review was to synthesize and appraise the scope and quality of South Asian T2D CPGs.
This PROPSERO registered (CRD42023425150) systematic review adhered to the 2020 PRISMA guidelines. We searched the PubMed, Embase, Cochrane, and Google Scholar databases for relevant guidelines. Data synthesis was performed using a qualitative approach and methodological quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool.
We identified eleven unique CPGs (three each from Pakistan and Sri Lanka, two from India, and one each from Bangladesh, Nepal, and Bhutan) which were published or updated between 2017 and 2023. The CPGs included recommendations regarding screening, diagnosis, prevention, and management of T2D and its acute and chronic complications, comorbidities, and fasting with T2D. The AGREE II mean domain scores ranged from 37 % to 80 %; three CPGs were 'recommended for clinical use,' seven were 'recommended for use with modifications' and one was deemed unfit for implementation.
The present review summarized and appraised broadly CPGs from South Asia for T2D and can help direct improvements to future iterations.
临床实践指南(CPGs)是管理 2 型糖尿病(T2D)的循证工具。本系统评价的目的是综合评估南亚 T2D CPG 的范围和质量。
本 PROSPERO 注册(CRD42023425150)系统评价遵循 2020 年 PRISMA 指南。我们在 PubMed、Embase、Cochrane 和 Google Scholar 数据库中搜索了相关指南。使用定性方法进行数据综合,并使用评估指南研究和评估(AGREE)II 工具评估方法学质量。
我们确定了 11 项独特的 CPG(来自巴基斯坦和斯里兰卡的各 3 项,来自印度的 2 项,来自孟加拉国、尼泊尔和不丹的各 1 项),这些 CPG 分别在 2017 年至 2023 年期间发布或更新。CPG 包括有关 T2D 及其急性和慢性并发症、合并症以及 T2D 空腹的筛查、诊断、预防和管理的建议。AGREE II 平均领域得分范围为 37%至 80%;3 项 CPG 被“推荐用于临床使用”,7 项被“推荐修改后使用”,1 项被认为不适合实施。
本综述总结和评估了南亚 T2D 的 CPG,有助于指导未来的迭代改进。