| 3,387 | 0 | 1659 |
| 下载次数 | 被引频次 | 阅读次数 |
随着医学研究的不断进步,糖尿病诊治理念不断更新,相关循证医学证据不断积累,《中国老年糖尿病诊疗指南(2024版)》于2024年2月正式发布。相较于旧版指南,新版指南强调老年糖尿病患者存在高度异质性,需多学科团队进行综合评估,建议采取分层次和个体化管理策略,并进一步强调“简约治疗理念”和“去强化治疗策略”,旨在促进老年糖尿病患者管理的规范化和合理化。本文从护理视角出发,针对新版指南的护理实践内容进行解读,以期为护理工作提供循证指导,提升护理服务质量。
Abstract:With the continuous progress of medical research, the concept of diabetes diagnosis and treatment is constantly updated, and relevant evidence-based medical evidence continues to accumulate, the Guideline for the Management of Diabetes Mellitus in the Elderly in China(2024 Edition) was officially released in 2024. Compared with the old version of the guidelines, the new guideline emphasized that the elderly with diabetes were highly heterogeneous, requiring comprehensive assessment by multidisciplinary teams, adopting hierarchical and individualized management strategies, and further emphasized "the minimalistic treatment concept" and "de-intensification of treatment strategies",which aimed to promote the standardization and rationalization of the management of elderly with diabetes.This paper interpreted the content of nursing practice in the new version guideline from a perspective of nursing, in order to provide evidence-based guidance for nursing work and improve the quality of nursing service.
[1] 中华人民共和国民政部.2023年民政事业发展统计公报[EB/OL].[2024-08-30].https://www.mca.gov.cn/n156/n2679/c1662004999980001204/attr/355717.pdf.
[2] ZHOU M G,WANG H D,ZENG X Y,et al.Mortality,morbidity,and risk factors in China and its provinces,1990—2017:a systematic analysis for the global burden of disease study 2017[J].The Lancet,2019,394(10204):1145-1158.
[3] 陈卫,董隽含.老龄化发展对我国人口健康转变的影响[J].人口与社会,2024,40(2):1-14.
[4] 国家老年医学中心,中华医学会老年医学分会,中国老年保健协会糖尿病专业委员会.中国老年糖尿病诊疗指南(2024版)[J].协和医学杂志,2024,15(4):771-800.
[5] SINCLAIR A,SAEEDI P,KAUNDAL A,et al.Diabetes and global ageing among 65-99-year-old adults:findings from the international diabetes federation diabetes atlas,9th edition[J].Diabetes Research and Clinical Practice,2020,162:108078.
[6] 中华人民共和国中央人民政府.《健康中国行动(2019—2030年)》[EB/OL].(2019-07-15)[2024-08-30].https://www.gov.cn/xinwen/2019-07/15/content_5409694.htm.
[7] 李晓鹏,张修齐,张敏华,等.老年高血压患者社区健康管理模式研究进展[J].现代医院,2024,24(3):452-456.
[8] 施赵维,季晓珍.医院—社区联动健康教育模式对社区2型糖尿病患者的管理效果评价[J].中国健康教育,2024,40(9):839-843.
[9] 夏胜岚,刘海娟.“互联网+” 背景下医院—社区—家庭三级健康教育模式对糖尿病患者生活质量的效果评价[J].基层医学论坛,2024,28(22):1-3,12.
[10] 张建平,李菲,杨俊霞.信息化跟踪式健康教育对2型糖尿病患者的应用效果及自我管理能力的影响[J].中华养生保健,2024(16):131-134.
[11] KNOWLER W C,BARRETT-CONNOR E,FOWLER S E,et al.Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin[J].The New England Journal of Medicine,2002,346(6):393-403.
[12] 张晓萌,李君.食养原则与建议——解读成人糖尿病食养指南(2023年版)[J].中国糖尿病杂志,2023,31(11):873-876.
[13] SHUKLA A P,DICKISON M,COUGHLIN N,et al.The impact of food order on postprandial glycaemic excursions in prediabetes[J].Diabetes,Obesity & Metabolism,2019,21(2):377-381.
[14] KUMAR A S,MAIYA A G,SHASTRY B A,et al.Exercise and insulin resistance in type 2 diabetes mellitus:a systematic review and meta-analysis[J].Annals of Physical and Rehabilitation Medicine,2019,62(2):98-103.
[15] JANSSON A K,CHAN L X,LUBANS D R,et al.Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength:a systematic review and meta-analysis[J].BMJ Open Diabetes Research & Care,2022,10(2):e002595.
[16] MORRISON S,COLBERG S R,MARIANO M,et al.Balance training reduces falls risk in older individuals with type 2 diabetes[J].Diabetes Care,2010,33(4):748-750.
[17] CHEN K,SHEN Z W,GU W J,et al.Prevalence of obesity and associated complications in China:a cross-sectional,real-world study in 15.8 million adults[J].Diabetes,Obesity and Metabolism,2023,25(11):3390-3399.
[18] WANG Y J,LIANG X Y,ZHOU Z A,et al.Prevalence and numbers of diabetes patients with elevated BMI in China:evidence from a nationally representative cross-sectional study[J].International Journal of Environmental Research and Public Health,2022,19(5):2989.
[19] 国家卫生健康委办公厅.肥胖症诊疗指南(2024年版)[EB/OL].(2024-10-12) [2024-11-15].https://www.gov.cn/zhengce/zhengceku/202410/content_6981734.htm.
[20] LEAN M E,LESLIE W S,BARNES A C,et al.Primary care-led weight management for remission of type 2 diabetes (DiRECT):an open-label,cluster-randomised trial[J].Lancet,2018,391(10120):541-551.
[21] POLEMITI E,BAUDRY J,KUXHAUS O,et al.BMI and BMI change following incident type 2 diabetes and risk of microvascular and macrovascular complications:the EPIC-Potsdam study[J].Diabetologia,2021,64(4):814-825.
[22] 李东玲,陈小燕,黄炯强,等.肥胖及超重2型糖尿病患者代谢手术后5年疗效随访研究[J].中国糖尿病杂志,2022,30(2):101-105.
[23] BUTT J H,PETRIE M C,JHUND P S,et al.Anthropometric measures and adverse outcomes in heart failure with reduced ejection fraction:revisiting the obesity paradox[J].European Heart Journal,2023,44(13):1136-1153.
[24] MORAES A D S,PADOVANI R D C,LA SCALA TEIXEIRA C V,et al.Cognitive behavioral approach to treat obesity:a randomized clinical trial[J].Frontiers in Nutrition,2021,8:611217.
[25] GORDON N P,YAO J H,BRICKNER L A,et al.Prevalence of sleep-related problems and risks in a community-dwelling older adult population:a cross-sectional survey-based study[J].BMC Public Health,2022,22(1):2045.
[26] CHEN Z M,PETO R,ZHOU M G,et al.Contrasting male and female trends in tobacco-attributed mortality in China:evidence from successive nationwide prospective cohort studies[J].Lancet,2015,386(10002):1447-1456.
[27] 中华医学会糖尿病学分会.中国血糖监测临床应用指南(2021年版)[J].中华糖尿病杂志,2021,13(10):936-948.
[28] LEELARATHNA L,EVANS M L,NEUPANE S,et al.Intermittently scanned continuous glucose monitoring for type 1 diabetes[J].The New England Journal of Medicine,2022,387(16):1477-1487.
[29] HU Z D,ZHANG K P,HUANG Y,et al.Compliance to self-monitoring of blood glucose among patients with type 2 diabetes mellitus and its influential factors:a real-world cross-sectional study based on the Tencent TDF-I blood glucose monitoring platform[J].mHealth,2017,3:25.
[30] 郑兰芳,曹悌鸿.2型糖尿病患者自我血糖监测现状调查及其影响因素[J].中国卫生工程学,2022,21(6):953-955,958.
[31] GUO L X,ZHANG Q,XUE Y M,et al.A nationwide cross-sectional survey of knowledge and practices of diabetes drug injection techniques of patients,nurses,and physicians:the China IT improve study[J].Mayo Clinic Proceedings,2023,98(10):1482-1500.
基本信息:
DOI:10.16821/j.cnki.hsjx.2025.19.006
中图分类号:R473.5
引用信息:
[1]李英霞,左燕雨,李文明,等.从护理学视角解读《中国老年糖尿病诊疗指南(2024版)》[J].护士进修杂志,2025,40(19):2048-2052.DOI:10.16821/j.cnki.hsjx.2025.19.006.
2025-05-07
2025-05-07
2025-05-07