NP-Supported Multidisciplinary Diabetes Management During Perioperative Period (NPMDM-PP)
14 de marzo de 2022 actualizado por: Peking University Third Hospital
NP-Supported Multidisciplinary Diabetes Management During Perioperative Period in Patient With Diabetes Mellitus
The primary objective of this study is to determine the benefits of interventions from a Multidisciplinary Diabetes Care team involved of diabetes nurse practitioners(DNP) on glucose control, perioperative outcomes and psychosocial outcomes for patients with Diabetes Mellitus
Descripción general del estudio
Estado
Aún no reclutando
Condiciones
Intervención / Tratamiento
Descripción detallada
About 50% of diabetic patients will undergo at least one surgical operation, and nearly 20% of surgical patients have diabetes.Compared with non-diabetic patients, diabetic patients face greater risks during the perioperative period. Stress factors such as preoperative preparation, anesthesia, surgical trauma, pain, drugs and negative emotions can induce blood glucose fluctuations, which could lead to complications such as hyperglycemia, diabetic ketosis, and hypoglycemia.Therefore, perioperative management has become an important part of diabetes management.
A multidisciplinary collaborative team led by NP can reduce the mortality of patients after inpatient surgery, help patients change their lifestyle, maintain self-management behavior, improve patient experience, and reduce hospitalization costs. This study intends to explore the application effect of NP-led multidisciplinary collaborative team in the perioperative comprehensive management of diabetic patients.
Tipo de estudio
Intervencionista
Inscripción (Anticipado)
170
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Estudio Contacto
- Nombre: Qun Wang
- Número de teléfono: 13901280942
- Correo electrónico: wq3025@sina.com
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Diagnosis meets World Health Organization (WHO) (1999) Diabetes Diagnostic Standards
- Orthopedic assessment requires elective surgery and no surgical contraindications
- HbA1c≥8.5% or intravenous fasting blood glucose (FBG)>10mmol/l
- Informed consent.
Exclusion Criteria:
- Cognitive and communication disorders;
- Pregnancy;
- Participate in other intervention studies.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Cuidados de apoyo
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: NP-Supported Multidisciplinary Diabetes Management
NP establishes files to evaluate and manage patients before hospital and visits patients after hospitalization.
Then set blood glucose control goals with endocrinology and orthopedic doctors together, initiates consultation with endocrinologists for patients with postoperative hyperglycemia, and is responsible for post-hospital follow-up.
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NP establishes files to evaluate and manage patients before hospital and visits patients after hospitalization.
Then set blood glucose control goals with endocrinology and orthopedic doctors together, initiates consultation with endocrinologists for patients with postoperative hyperglycemia, and is responsible for post-hospital follow-up.
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Sin intervención: Regular diabetes management
The patient would go to the endocrinology outpatient clinic before hospitalization to regulate blood glucose, and be managed by by orthopedic medical staff through hospitalization.
If necessary, the endocrinologist is consulted.
And after the hospital, patients would be followed up by orthopedic medical staff.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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EFFICACY: TIR（Time in Range）
Periodo de tiempo: From into the group to the first hospital day; First day in hospital to the day of discharge
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Time in range
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From into the group to the first hospital day; First day in hospital to the day of discharge
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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EFFICACY: Glycated Serum Protein
Periodo de tiempo: baseline and 1 month after discharged
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Glycated Serum Protein would be conducted to measure glucose control
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baseline and 1 month after discharged
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EFFICACY: Incidence of perioperative hypoglycemia
Periodo de tiempo: From into the grop to 1 month after surgery. And confirmed based on the patient's main complaint and monitoring records.
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Incidence of perioperative hypoglycemia would be conducted to measure glucose control
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From into the grop to 1 month after surgery. And confirmed based on the patient's main complaint and monitoring records.
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EFFICACY: Time required for blood glucose standard before surgery
Periodo de tiempo: the first hospital day
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The time from the patient's enrollment to the blood glucose reaching the blood glucose control target
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the first hospital day
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EFFICACY: Diabetes self-management behavior
Periodo de tiempo: Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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measured by Summary of Diabetes Self-Care Activities（SDSCA）.
SDSCA scores from 0 to 77 and higher score means better self-management behaviors.
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Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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EFFICACY: Incidence of perioperative adverse events
Periodo de tiempo: 1 month after discharge
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Adverse events included wound infection, prolonged wound healing time, and death within 1 month after surgery.
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1 month after discharge
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EFFICACY: Blood pressure
Periodo de tiempo: baseline, day of hospitalization, during hospitalization and 1 month after discharge
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A calibrated electronic blood pressure meter of the same brand was used to measure systolic pressure and diastolic pressure in the same arm at the same time daily
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baseline, day of hospitalization, during hospitalization and 1 month after discharge
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EFFICACY: Body weight
Periodo de tiempo: baseline, day of hospitalization, during hospitalization and 1 month after discharge
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The same scale was used to measure after patients got up in the morning.
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baseline, day of hospitalization, during hospitalization and 1 month after discharge
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EFFICACY: Anxiety and depression
Periodo de tiempo: Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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measured by Hospital Anxiety and Depression Scale (HADS) scale.
HADS contains two subscales: anxiety and depression, and each subscale have 7 items.
Total scores were from 0 to 42(anxiety: 21 scores; depression: 21 scores), higher score means more severe anxiety and/or depression.
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Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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QUALITY OF LIFE:living quality
Periodo de tiempo: Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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measured by Short Form 36 Health Survey (SF-36) which contains 8 modules with different score formula.
Higher total scores mean better living quality.
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Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Publicaciones Generales
- Golden SH, Peart-Vigilance C, Kao WH, Brancati FL. Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes. Diabetes Care. 1999 Sep;22(9):1408-14. doi: 10.2337/diacare.22.9.1408.
- Liao CC, Lin CS, Shih CC, Yeh CC, Chang YC, Lee YW, Chen TL. Increased risk of fracture and postfracture adverse events in patients with diabetes: two nationwide population-based retrospective cohort studies. Diabetes Care. 2014 Aug;37(8):2246-52. doi: 10.2337/dc13-2957. Epub 2014 May 7. Erratum In: Diabetes Care. 2017 Jun 14;:
- Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG, Hirsch IB; American Diabetes Association Diabetes in Hospitals Writing Committee. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004 Feb;27(2):553-91. doi: 10.2337/diacare.27.2.553. No abstract available. Erratum In: Diabetes Care. 2004 Mar;27(3):856. Hirsh, Irl B [corrected to Hirsch, Irl B]. Diabetes Care. 2004 May;27(5):1255.
- Meneghini LF. Perioperative management of diabetes: translating evidence into practice. Cleve Clin J Med. 2009 Nov;76 Suppl 4:S53-9. doi: 10.3949/ccjm.76.s4.09.
- Sebranek JJ, Lugli AK, Coursin DB. Glycaemic control in the perioperative period. Br J Anaesth. 2013 Dec;111 Suppl 1:i18-34. doi: 10.1093/bja/aet381.
- Aminian A, Kashyap SR, Burguera B, Punchai S, Sharma G, Froylich D, Brethauer SA, Schauer PR. Incidence and Clinical Features of Diabetic Ketoacidosis After Bariatric and Metabolic Surgery. Diabetes Care. 2016 Apr;39(4):e50-3. doi: 10.2337/dc15-2647. Epub 2016 Jan 28. No abstract available.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Anticipado)
1 de abril de 2022
Finalización primaria (Anticipado)
31 de marzo de 2023
Finalización del estudio (Anticipado)
31 de marzo de 2023
Fechas de registro del estudio
Enviado por primera vez
29 de diciembre de 2021
Primero enviado que cumplió con los criterios de control de calidad
14 de marzo de 2022
Publicado por primera vez (Actual)
23 de marzo de 2022
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
23 de marzo de 2022
Última actualización enviada que cumplió con los criterios de control de calidad
14 de marzo de 2022
Última verificación
1 de diciembre de 2021
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- M2021609
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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