Zhongguo quanke yixue (Nov 2022)

Evidence Summary for Management of Nail Diseases in Patients with Diabetes

  • CHEN Huan, HOU Chaoming, GAO Jing, BAI Dingxi, WU Chenxi, WANG Hao, YOU Qian, XIAN Yuanyuan

DOI
https://doi.org/10.12114/j.issn.1007-9572.2022.0362
Journal volume & issue
Vol. 25, no. 32
pp. 3984 – 3990

Abstract

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Background Timely identification and proper treatment of nail disease is of great significance to the prevention of foot ulcer in diabetes. However, insufficient understanding of nail disease is highly prevalent in clinical workers. What's more, there is a lack of a summary of the best evidence about clinical management of nail diseases in diabetes in China. Objective To comprehensively retrieve and analyze evidence about the management of nail disease in diabetes, and give a summary of the best evidence. Methods We searched databases of BMJ Best Practice, UpToDate, WHO, Guidelines International Network, NICE, National Guideline Clearinghouse, RNAO, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, Yimaitong, JBI, PubMed, Embase, CINAHL, CNKI and Wanfang Data for clinical decisions, guidelines, systematic reviews and expert consensuses regarding the management of nail diseases in diabetes included as of December 6, 2021. Then we evaluated the quality of the evidence, and rated it according to the 2016 Supporting Document for the Joanna Briggs Institute Levels of Evidence and Grades of Recommendation, and summarized the best evidence. Results A total of 8 studies were enrolled, including 1 about clinical decisions, 4 guidelines and 3 expert consensuses. The clinical decisions was from the UpToDate and directly included. Two guidelines were rated B, and the other 2 were rated A, all of which were allowed to be included. All the expert consensuses showed a high level of quality, and were allowed to be included. Finally, 9 items of best evidence regarding nail disease assessment, handling and health education were summarized, including 5 A-level recommendations and 4 B-level recommendations. Conclusion This study searched the clinical decisions, guidelines and expert consensus related to the management of patients with diabetes mellitus, and summarized the best evidence of the management of patients with diabetes mellitus. The evidence involves three aspects: nail disease assessment, handling and health education were summarized, and the levels were A-level recommendation and B-level recommendation. Our summary of the best evidence could be used as evidence-based basis for early clinical assessment and treatment of nail disease in diabetes.

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