没有麻醉医师参与的围术期血糖管理指南

Review Diabetes Metab Res Rev

. 2021 Oct;37(7):e3439. doi: 10.1002/dmrr.3439. Epub 2021 Feb 19.

Chinese clinical practice guidelines for perioperative blood glucose management

Wang Jinjing 1 2, Chen Kang 1, Luo Xufei 3, Li Xueqiong 4, Jin Xinye 1 5, Yu Miao 6, Zhang Jinping 7, Lv Zhaohui 1, Dou Jingtao 1, Chen Yaolong 8 9 10, Ji Linong 11, Mu Yiming 1; Guideline Steering Group; Guideline Development Group; Chinese Society of Endocrinology of Chinese Medical Association

Affiliations expand

• PMID: 33605539 DOI: 10.1002/dmrr.3439

Abstract

With the increased incidence of diabetes, the number of diabetic patients who require surgical treatment is also increasing. Unfortunately, practices in this area lack standardisation. The purpose of this multidisciplinary, evidence-based guidelines for perioperative blood glucose management is to provide a comprehensive set of recommendations for clinicians treating diabetes with different types of surgery. The intended audience comprises Chinese endocrinologists, surgeons, anaesthetists, clinical pharmacists, nurses and professionals involved in perioperative blood glucose management. The guidelines were formulated as follows. First, a multidisciplinary expert group was established to identify and formulate key research questions on topics of priority according to the Population, Intervention, Comparator and Outcomes (PICO) process. We conducted a meta-analysis of available studies using Review Manager version 5.3, as appropriate. We pooled crude estimates as odds ratios with 95% confidence intervals using a random-effects model, and used the Grading of Recommendations Assessment, Development, and Evaluation methods to assess the quality of the retrieved evidence. Finally, 32 recommendations were gathered that covered 11 fields-management and coordination, endocrinologists' consultation, diabetes diagnosis, surgery timing and anaesthesia method, blood glucose target values and monitoring frequency, hypoglycaemia treatment, oral administration of blood glucose lowering drugs, use of insulin, enteral and parenteral nutritional, postoperative treatment and medication and education and training. Twenty-five systematic reviews and meta-analyses were conducted for these guidelines to address the PICO questions. These guidelines are intended to improve perioperative blood glucose management and help doctors in specifying medical diagnosis and treatment, and will be implemented / disseminated extensively in China.

Keywords: blood glucose; clinical practice guideline; diabetes; surgery; systematic reviews.