International guidelines for perioperative blood-glucose management: Epidemiological studies and quality evaluation

Tags: Poster
Wang J1, Chen K2, Li X3, Mu Y2, Chen Y4
1Affiliated Hospital of Academy of Military Medical Sciences (PLA 307 Hospital) Beijing,100071, 2Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, 3Department of Gerontology, First Affiliated Hospital of Kunming Medical University, Kunming 650031, 4Evidence-Based Medicine Center, Basic Medical Sciences, Lanzhou University, Lanzhou 730000

Background: In recent years, a number of countries and organisations around the world have published guidelines for perioperative blood-glucose management, but there is no relevant study on their epidemiology and methodological quality.

Objectives: To investigate the recent advance of epidemiology and methodological quality of the global perioperative blood glucose management guidelines.

Methods: Two independent researchers searched Medline, CBM, Chinese National Knowledge Infrastructure (CNKI), Wan Fang, Guidelines International Network library, National Guideline Clearinghouse. They have also conducted a supplemental search on the guidelines by using the search engines. Both index time ended at 31 December 2015, and the guide was evaluated by using AGREE II for the methodological quality assessment.

Results: A total of 15 guideline articles related to the perioperative blood-glucose management were included. Among these, 4 articles were from United States, 3 from China, and 2 each from the United Kingdom and Australia. The contents include perioperative blood-glucose monitoring, nursing care, drug usage, patient education, etc. The recommendations on the management, especially on the blood glucose control level and monitoring frequency, from these articles are not consistent with each other. The evaluation from the AGREE II results showed that the highest average score of the 15 guidelines was in the field of 4 with a 51%, The lowest score was 3 in the field, with an average score of only 16%, and the average scores of other fields were in the range of 15%~50%.

Conclusions: The global perioperative blood glucose management guidelines cover a wide range of recommendations, but the recommendations of the inter-organisational guidelines are inconsistent. The methodological quality needs to be improved, particularly on the rigour and independence of the guidelines.