NP-Supported Multidisciplinary Diabetes Management During Perioperative Period (NPMDM-PP)
14 de março de 2022 atualizado 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
Visão geral do estudo
Status
Ainda não está recrutando
Condições
Intervenção / Tratamento
Descrição detalhada
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 estudo
Intervencional
Inscrição (Antecipado)
170
Estágio
- Não aplicável
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Contato de estudo
- Nome: Qun Wang
- Número de telefone: 13901280942
- E-mail: wq3025@sina.com
Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
18 anos e mais velhos (Adulto, Adulto mais velho)
Aceita Voluntários Saudáveis
Não
Gêneros Elegíveis para o Estudo
Tudo
Descrição
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.
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Cuidados de suporte
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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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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Sem intervenção: 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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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
EFFICACY: TIR（Time in Range）
Prazo: 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 resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
EFFICACY: Glycated Serum Protein
Prazo: baseline and 1 month after discharged
|
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
Prazo: 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
Prazo: the first hospital day
|
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
Prazo: 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.
|
Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
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EFFICACY: Incidence of perioperative adverse events
Prazo: 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
Prazo: baseline, day of hospitalization, during hospitalization and 1 month after discharge
|
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
Prazo: baseline, day of hospitalization, during hospitalization and 1 month after discharge
|
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
Prazo: Measurements were taken at baseline, day of hospitalization, and 1 month after discharge
|
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
Prazo: 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
|
Colaboradores e Investigadores
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Patrocinador
Colaboradores
Publicações e links úteis
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Publicações Gerais
- 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.
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Antecipado)
1 de abril de 2022
Conclusão Primária (Antecipado)
31 de março de 2023
Conclusão do estudo (Antecipado)
31 de março de 2023
Datas de inscrição no estudo
Enviado pela primeira vez
29 de dezembro de 2021
Enviado pela primeira vez que atendeu aos critérios de CQ
14 de março de 2022
Primeira postagem (Real)
23 de março de 2022
Atualizações de registro de estudo
Última Atualização Postada (Real)
23 de março de 2022
Última atualização enviada que atendeu aos critérios de controle de qualidade
14 de março de 2022
Última verificação
1 de dezembro de 2021
Mais Informações
Termos relacionados a este estudo
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- M2021609
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Não
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Não
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Ensaios clínicos em NP-Supported Multidisciplinary Diabetes Management
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Vegenat, S.A.DesconhecidoHiperglicemia | Síndrome metabólica | DiabéticosEspanha