Abstract
Objectives
Recommendations from clinical practice guidelines (CPGs) for individuals with type
2 diabetes mellitus (T2DM) may be inconsistent, and little is known about their quality.
Our aim in this study was to systematically review the consistency of globally available
CPGs containing nutritional recommendations for T2DM and to assess the quality of
their methodology and reporting.
Methods
PubMed, China Biology Medicine and 4 main guideline websites were searched. Four researchers
independently assessed quality of the methodology and reporting using the Appraisal
of Guidelines for Research and Evaluation, second edition (AGREE II) instrument and
the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist.
Results
Fifteen CPGs include 65 nutritional recommendations with 6 sections: 1) body weight
and energy balance; 2) dietary eating patterns; 3) macronutrients; 4) micronutrients
and supplements; 5) alcohol; and 6) specific, functional foods. Current nutritional
recommendations for individuals with T2DM on specific elements and amounts are not
completely consistent in different CPGs and fail to assign the specific supporting
evidence and strength of recommendations. To use nutritional recommendations to guide
and manage individuals with T2DM, it is important to address the current challenges
by establishing a solid evidence base and indicating the strength of recommendations.
Overall, 8 CPGs classified as recommended for clinical practice used AGREE II. Fifteen
CPGs adhere to <60% of RIGHT checklist items.
Conclusions
High-quality evidence is needed to potentially close knowledge gaps and strengthen
the recommendation. The AGREE II instrument, along with the RIGHT checklist, should
be endorsed and used by CPG developers to ensure higher quality and adequate use of
their products.
Résumé
Objectifs
On sait que les recommandations des lignes directrices de pratique clinique (LDPC)
destinées aux patients atteints du diabète sucré de type 2 (DST2) peuvent être contradictoires,
mais on en sait peu sur leur qualité. L’objectif de notre étude était d’examiner de
façon systématique la cohérence des LDPC disponibles dans le monde entier qui contiennent
des recommandations nutritionnelles lors de DST2 et d’évaluer la qualité de leur méthodologie
et de leurs rapports.
Méthodes
Nous avons effectué des recherches dans PubMed, China Biology Medicine et les 4 principaux
sites Web de lignes directrices. Quatre chercheurs ont évalué de façon indépendante
la qualité de la méthodologie et des rapports à l’aide de l’outil Appraisal of Guidelines
for Research and Evaluation, deuxième édition (AGREE II) et de la liste de vérification
Reporting Items for Practice Guidelines in HealThcare (RIGHT).
Résultats
Quinze LDPC regroupaient 65 recommandations nutritionnelles en 6 sections : 1) le
poids corporel et le bilan énergétique; 2) les habitudes de consommation alimentaire;
3) les macronutriments; 4) les micronutriments et les suppléments; 5) l’alcool; 6)
les aliments fonctionnels ou particuliers. Les recommandations nutritionnelles actuelles
destinées aux patients atteints du DST2 concernant les éléments et les quantités spécifiques
ne sont pas entièrement cohérentes entre les différentes LDPC et ne fournissent pas
de données probantes à l’appui ni la force des recommandations. En vue d’utiliser
les recommandations nutritionnelles pour orienter et prendre en charge les patients
atteints du DST2, il est important de surmonter les difficultés actuelles en établissant
un corpus de données scientifiques solides et en indiquant la force des recommandations.
Dans l’ensemble, 8 LDPC classifiées selon les recommandations de pratique clinique
utilisaient AGREE II. Quinze LDPC adhèrent à < 60 % des questions de la liste de vérification
RIGHT.
Conclusions
Des données probantes de haute qualité sont nécessaires pour potentiellement combler
les lacunes en matière de connaissances et renforcer les recommandations. Les auteurs
des LDPC devraient approuver et appliquer l’outil AGREE II parallèlement à la liste
de vérification RIGHT afin de garantir une qualité accrue et une utilisation adéquate
de leurs produits.
Keywords
Mots clés
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Article info
Publication history
Published online: September 01, 2022
Accepted:
August 12,
2022
Received in revised form:
June 13,
2022
Received:
September 27,
2021
Identification
Copyright
© 2022 Canadian Diabetes Association.
