2023年Journal of Diabetes第6期中文导读

Use of basal insulin in the management of adults with type 2 diabetes:an Asia-Pacific evidence-based clinical

综述/Review Article使用基础胰岛素治疗成人2型糖尿病:亚太地区循证临床实践指南Use of basal insulin in the management of adults with type 2 diabetes:an Asia-Pacific evidence-based clinical practice guideline Linong Ji1,Yingying Luo1,Yong Mong Bee2,Jun Xia3,4,Nguyen Khue Thy5,Weigang Zhao6,Liming Chen7,Siew Pheng Chan8,Chaicharn Deerochanawong9,Soo Lim10,Daisuke Yabe11,12,Margaret McGill13,Ketut Suastika14,Xiaoying Li15,Alice Pik Shan Kong16,Wei Chen17,Zhan Zhao18,Chenchen Xu18,Marisa Deodat19,Xiaomei Yao20,211Department of Endocrinology and Metabolism,Peking University People′s Hospital,Beijing,100044,China;2Department of Endocrinology,Singapore General Hospital,169608,Singapore;3Nottingham Ningbo GRADE Centre,University of Nottingham Ningbo China,Ningbo,Zhejiang,315100,China;4Academic Unit of Lifespan and Population Health,School of Medicine,The University of Nottingham,Nottingham,NG72UH,UK;5Ho Chi Minh University of Medicine and Pharmacy Medic Medical Center,Ho Chi Minh City,700000,Vietnam;6Department of Endocrinology,Peking Union Medical College Hospital,Beijing,100730,China;7Chu Hsien-I Memorial(Metabolic Diseases)Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin,300134,China;8Department of Medicine,Faculty of Medicine,University of Malaya,Lembah Pantai 59100 Kuala Lumpur,Malaysia;9College of Medicine,Rangsit University,Bangkok,10400,Thailand;10Department of Internal Medicine,Seoul National University College of Medicine and Seoul National University Bundang Hospital,Seongnam,13620,South Korea;11Departments of Diabetes,Endocrinology and Metabolism/Rheumatology and Clinical Immunology,Gifu University Graduate School of Medicine,Gifu,501-1194,Japan;12Center for One Medicine Innovative Translational Research,Gifu University Institute for Advanced Study,Gifu,501-1194,Japan;13Diabetes Centre,Royal Prince Alfred Hospital,Faculty of Medicine and Health University of Sydney,Sydney,New South Wales,2050,Australia;14Division of Endocrinology and Metabolism,Department of Internal Medicine,Faculty of Medicine,Udayana University,Prof.IGNG Ngoerah Hospital,Denpasar,Bali,80114,Indonesia;15Department of Endocrinology and Metabolism,Zhongshan Hospital,Fudan University,Shanghai,200032,China;16Division of Endocrinology,Department of Medicine and Therapeutics,The Chinese University of Hong Kong,Hong Kong Special Administrative Region,999077,China;17Department of Clinical Nutrition,Department of Health Medicine,Chinese Academy of Medical Sciences-Peking Union Medical College,Peking Union Medical College Hospital,Beijing,100730,China;18Tianjin Tiantian Biotechnology Co.,Ltd.Tianjin,300000,China;19Michael G.DeGroote Cochrane Canada and McMaster GRADE Centres,McMaster University,Hamilton,Ontario,L8V 5C2,Canada;20Center for Clinical Practice Guideline Conduction and Evaluation,Children′s Hospital of Fudan University,Shanghai,201100,China;21Department of Health Research Methods,Evidence,and Impact,McMaster University,Hamilton,Ontario,L8V 5C2,Canada【提要】为亚太地区初次使用胰岛素的成人2型糖尿病患者提供关于5种基础胰岛素(甘精胰岛素U-300、德谷胰岛素U-100、甘精胰岛素U-100型、地特胰岛素和中性鱼精蛋白胰岛素)的有效性、安全性、最佳起始剂量、最佳维持剂量范围和目标空腹血浆葡萄糖的推荐。基于系统回顾的证据,本综述通过全面的内部审核和外部审核流程制定了亚太地区临床实践指南。本综述在整体证据确定性评估中为不同重要和关键结局设置了微小、小、中等和大效应的临床阈值,并遵循GRADE(评估、发展、评价、建议的分级)方法来平衡干预效果的大小以进行推荐。本综述遵守了AGREE(指南评估、研究和评估)和RIGHT(卫生保健实践指南报告项目)指南报告检查清单。在工作组成员进行第二轮投票后,所有推荐和限定性陈述的一致率均达到了75%以上。在联系的44名外部评审人员中,本研究收到了33名临床医生和1例患者的意见,总体应答率为77%。为解决4个研究问题,本研究提出了2个强烈推荐、6个有条件推荐和2个限定性陈述。尽管本指南的预期用户主要是亚太地区的临床医生,但所选的证据基于最近的英文出版物。本综述提示,指南中制定的推荐和临床阈值可以成为全球关注2型糖尿病患者的临床医生的参考。