Xeris Pharmaceuticals, Inc., Publications and Medical Communications, Chicago, Illinois.
Sr Care Pharm. 2024 Oct 1;39(10):373-381. doi: 10.4140/TCP.n.2024.373.
Older people with diabetes are at high risk for hypoglycemia. Implementing a hypoglycemia treatment protocol in long-term care (LTC) settings may positively affect patient-related outcomes and health care resource utilization and costs. Anecdotal experience indicates little has been studied and published regarding this clinical practice. To identify hypoglycemia treatment protocols established for LTC settings and assess their effects on patient-related outcomes and health care resource use. The authors performed a systematic literature search of English-language articles and abstracts published between January 1, 2003 (PubMed), or 2018 (Google Scholar) and May 10, 2023. Search terms were "hypoglycemia," "diabetes mellitus," "longterm care," "nursing facilities," "assisted living facilities," "geriatrics," "elderly," "aged," "disabled," "disease management," "evidence-based medicine," "clinical protocols," "guideline," "glucagon," and/or "blood glucose." Included were publications with hypoglycemia treatment and management protocols or hypoglycemia-specific recommendations for LTC settings. DATA SYNTHESIS: The authors identified 405 articles and abstracts, removed 36 duplicates, screened 369 titles/ abstracts, and analyzed the full text for 93. Five met the inclusion criteria. Two originated from the American Diabetes Association: 2016 position statement regarding the management of diabetes in LTC and skilled nursing facilities, and 2023 standard-of-care guideline for managing older people with diabetes. One included the results after implementing an overall diabetes clinical care management algorithm in LTC facilities. A 2020 abstract and 2019 article were the only 2 publications involving specific hypoglycemia treatment protocols in LTC settings. This systematic literature search identified lack of published hypoglycemia treatment protocols in LTC settings and their effects on patient outcomes.
患有糖尿病的老年人有发生低血糖的高风险。在长期护理（LTC）环境中实施低血糖治疗方案可能会对患者相关结局以及医疗保健资源的利用和成本产生积极影响。一些传闻经验表明，针对这种临床实践，研究和发表的内容很少。本研究旨在确定为 LTC 环境制定的低血糖治疗方案，并评估其对患者相关结局和医疗保健资源利用的影响。作者对 2003 年 1 月 1 日（PubMed）或 2018 年（Google Scholar）至 2023 年 5 月 10 日期间发表的英文文章和摘要进行了系统的文献检索。检索词为“低血糖”、“糖尿病”、“长期护理”、“护理院”、“辅助生活设施”、“老年病学”、“老年人”、“老年”、“残疾”、“疾病管理”、“循证医学”、“临床方案”、“指南”、“胰高血糖素”和/或“血糖”。纳入的研究包括低血糖治疗和管理方案或针对 LTC 环境的低血糖特定建议的出版物。数据综合：作者共识别出 405 篇文章和摘要，去除 36 篇重复内容，筛选 369 篇标题/摘要，并分析了 93 篇全文。符合纳入标准的有 5 篇。其中 2 篇来源于美国糖尿病协会：2016 年关于 LTC 和熟练护理设施中糖尿病管理的立场声明，以及 2023 年管理老年人糖尿病的标准护理指南。一篇纳入了在 LTC 设施中实施整体糖尿病临床护理管理算法后的结果。一篇 2020 年的摘要和一篇 2019 年的文章是唯一涉及 LTC 环境中具体低血糖治疗方案的 2 篇出版物。本系统的文献检索确定了 LTC 环境中缺乏已发表的低血糖治疗方案及其对患者结局的影响。
