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非重症患者医院高血糖的筛查与管理:巴西糖尿病协会(SBD)的立场声明

Screening and management of hospital hyperglycemia in non-critical patients: a position statement from the Brazilian Diabetes Society (SBD).

作者信息

Marino Emerson Cestari, Momesso Denise, Toyoshima Marcos Tadashi Kakitani, de Almeida Maria Fernanda Ozorio, Schaan Beatriz D, Negretto Leandra Anália Freitas, Santomauro Junior Augusto Cezar, Cukier Priscilla, Genestreti Paulo Roberto Rizzo, Feitosa Alina Coutinho Rodrigues, da Silva Soares Pinto Jorge Eduardo, Ribeiro Rogerio Silicani, Lamounier Rodrigo Nunes, Lyra Ruy, Bertoluci Marcello Casaccia

机构信息

Curitiba Diabetes Center, Curitiba, Brazil.

Endocrinology and Metabolism Service, Hospital Nossa Senhora das Graças, Curitiba, Brazil.

出版信息

Diabetol Metab Syndr. 2025 Feb 12;17(1):54. doi: 10.1186/s13098-025-01585-z.

Abstract

BACKGROUND

Hospital Hyperglycemia (HH) is linked to poorer outcomes, including higher mortality rates, increased ICU admissions, and extended hospital stays, and occurs in both people living with diabetes or not. The prevalence of HH in non-critical patients ranges from 22 to 46%. This panel reviewed the evidence and made recommendations for the best care for hospitalized hyperglycemic patients, with or without diabetes mellitus.

METHODS

The methodology was published previously and was defined by the internal institutional steering committee. The SBD Acute and Hospital Complications Department drafted the manuscript, selecting key clinical questions for a narrative review using MEDLINE via PubMed. The best available evidence was reviewed, including randomized clinical trials (RCTs), meta-analyses, and high-quality observational studies related to Hospital Hyperglycemia.

RESULTS AND CONCLUSIONS

The department members and external experts developed 23 recommendations for the management of patients with HH, including screening, initial interventions, treatment adjustments, and care for potential complications. Based on the best available evidence, our article provides safe and effective management strategies for both public and private healthcare settings.

摘要

背景

医院高血糖(HH)与较差的预后相关,包括更高的死亡率、增加的重症监护病房(ICU)入院率和延长的住院时间,且在糖尿病患者和非糖尿病患者中均会发生。非重症患者中HH的患病率在22%至46%之间。该小组审查了相关证据,并就住院高血糖患者(无论是否患有糖尿病)的最佳护理提出了建议。

方法

该方法先前已发表,由内部机构指导委员会定义。SBD急性病及医院并发症科起草了手稿,通过PubMed使用MEDLINE为叙述性综述选择关键临床问题。审查了现有最佳证据,包括与医院高血糖相关的随机临床试验(RCT)、荟萃分析和高质量观察性研究。

结果与结论

部门成员和外部专家制定了23条关于HH患者管理的建议,包括筛查、初始干预、治疗调整以及对潜在并发症的护理。基于现有最佳证据,我们的文章为公共和私立医疗机构提供了安全有效的管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d56/11823188/1c03575d3344/13098_2025_1585_Fig1_HTML.jpg

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