Abstract:

Objective To identify,evaluate and summarize the best evidence of a low-carbohydrate diet for type 2 diabetes mellitus management and remission,and to provide evidence for clinical nursing practice and self-management of patients of type 2 diabetes. Methods Literature published between January 2016 and July 2021 from electronic databases （Guidelines International Network,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Joanna Briggs Institute,Cochrane Library,American Diabetes Association Website,Medlive.cn,CNKI,WanFang Data,Cqvip.com,PubMed,Web of Science,and Embase） was retrieved. The types of literature included guidelines,consensuses,evidence summaries,best practice,systematic reviews and meta-analysis. The Appraisal of Guidelines for Research & Evaluation Instrument Ⅱ （AGREE Ⅱ） and A Measurement Tool to Assess Systematic Reviews 2（AMSTAR 2） were employed for evaluating the quality of the included studies,and the Grading of Recommendations Assessment,Development and Evaluation （GRADE） were used to rate the quality level of evidence. Results 216 references were obtained by the initial retrieval,and 31 were finally included. 33 pieces of best evidence from 6 aspects on safeness,risks,effects,duration and process,applicable population and food recommendations were summarized. Conclusion Short- and medium-term applications of a low-carbohydrate diet in type 2 diabetes with the supervision of professionals were safe and effective. Clinical nurses can apply the summarized evidence to the health education on the low-carbohydrate diet of type 2 diabetes patients as appropriate,and they should better consider and combine with clinical diagnosis and treatment,and manage the disease with more evidence-based approaches.

Key words: Diabetes Mellitus,Type 2, Diet,Carbohydrate-Restricted, Diet Therapy, Evidence-Based Nursing

摘要：

目的 检索、评价并总结2型糖尿病患者低碳水化合物膳食干预的最佳证据,为临床护理实践及患者自我管理提供循证依据。 方法 计算机检索国际指南协作网、英国国家卫生与临床优化研究所、苏格兰学院间指南网络、澳大利亚乔安娜布里格斯循证护理中心、Cochrane Library、美国糖尿病协会网站、医脉通指南网、中国知网、万方知识数据服务平台、维普数据库、PubMed、Web of Science、Embase中关于低碳水化合物膳食控制2型糖尿病疾病进展的所有证据,证据类型包括指南、专家共识、证据总结、证据实践、系统评价和Meta分析,检索时限为2016年1月—2021年7月。采用临床指南研究与评价系统Ⅱ、系统综述评价评估工具Ⅱ及证据推荐分级、评估、制订与评价系统进行文献质量和证据质量评定。 结果 初步检索共获得文献216篇,最终共纳入文献31篇,汇总了33条最佳证据,包括低碳水化合物膳食缓解2型糖尿病患者病情的安全性、风险、干预效果、干预时间与程序、适用人群及饮食建议等6个方面。 结论 在专业人员辅助下,低碳水化合物膳食在2型糖尿病患者中的中短期应用是安全有效的。临床护士可以应用证据总结,结合实际情况,酌情向患者进行低碳水化合物膳食相关的健康宣教,配合临床诊疗,科学控制疾病进展。

关键词: 糖尿病,2型, 膳食,低碳水化合物, 膳食疗法, 循证护理学