论文部分内容阅读
目的:本研究旨在总结2型糖尿病（T2DM）营养管理最佳证据，为制订营养管理方案提供参考。方法:按照“6S”证据模型，系统检索与筛选专业团体网站、临床实践指南网站、数据库的T2DM营养管理相关循证指南、专家共识、系统评价等，采用AGREEⅡ对指南进行方法学质量评价，根据澳大利亚Joanna Briggs Institute（JBI）循证卫生保健中心质量评价标准对系统评价、专家共识等进行质量评价；按照证据综合原则对内容相同或相似的推荐条目进行综合，结论冲突的证据进行研究小组讨论；最后遴选出适宜我国国情的T2DM营养管理的推荐意见。结果:共检索国内外文献5 399篇，最终纳入19篇文献，包括8篇指南、1篇专家共识、10篇系统评价。其中，1篇指南质量评价结果为A级，7篇指南质量评价结果为B级，系统评价和专家共识评价结果均为推荐。按照证据综合原则将推荐意见综合后，总结出包括营养管理方式、营养筛查与评估、能量需求、宏量营养素摄入、微量营养素摄入5个方面，共29条最佳证据。结论:成人T2DM营养管理的证据较广泛但数量有限。宏量营养素有较为相似的推荐意见，但微量营养素尚缺乏高质量证据，尤其在是否有必要进行常规微量元素补充及具体摄入量方面，需要进行更多的实践探索及科学研究来丰富T2DM领域的相关证据。“,”Objective:To summarize the best evidence for nutrition management of type 2 diabetes mellitus (T2DM) , so as to provide a reference for formulating nutrition management plans.Methods:According to the “6S” evidence model, evidence-based guidelines, expert consensus, and systematic reviews on nutrition management for T2DM were systematically searched and screened in professional group websites, clinical practice guideline websites and databases. The Appraisal of Guidelines for Research and Evaluation (AGREE) Ⅱwas used to assess the methodological quality of the guideline. Quality evaluation of systematic reviews and expert consensus was conducted according to the appraisal system of the Australian Joanna Briggs Institute (JBI) Evidence-based Health Care Center. The recommended items with the same or similar content were synthesized according to the principle of evidence synthesis, and group discussion was carried out on evidence of conflicting conclusions. The recommendations for nutrition management of T2DM suitable for our national conditions were selected.Results:A total of 5 399 domestic and foreign articles were searched, and 19 articles were finally included, including 8 guidelines, 1 expert consensus, and 10 systematic reviews. The quality evaluation results of 1 guideline were grade A, and 7 guidelines were grade B, and the results of systematic review and expert consensus evaluation were both recommended. According to the principle of evidence synthesis, the recommendations were synthesized, including 5 aspects, namely nutrition management methods, nutrition screening and assessment, energy requirements, macronutrient intake, and micronutrient intake, with a total of 29 pieces of best evidence.Conclusions:Evidence on nutrition management of adults with T2DM is extensive but limited. Macronutrients have similar recommendations. However, there is still a lack of high-quality evidence for micronutrients, especially in terms of whether routine micronutrient supplementation is necessary and the specific intake. Extensive practical exploration and scientific research are needed to enrich the relevant evidence in the field of T2DM.