Empowering county-level experts to authoritatively explain the "National Grassroots Diabetes Prevention and Management Guidelines (2022)"

In March 2022, the "National Guidelines for the Prevention and Management of Diabetes at the Grassroots Level (2022)" (hereinafter referred to as the new "Guidelines"), which guides grassroots medical staff to provide comprehensive and continuous diabetes health management services to residents, was officially promulgated
.

The release of the Guidelines will further standardize the behavior of primary clinical diagnosis and treatment, help doctors provide better diagnosis and treatment plans for patients, and benefit the majority of patients and medical workers
.

On April 22, the China Rural Health Association organized a special training meeting for the new version of the "Guide" for the grassroots through the "Healthy China, Empowering County"-general practitioner series of training programs
.

This meeting aims to promote the majority of grassroots doctors to learn the new guideline and further improve the skills of grassroots diabetes health management
.

The meeting specially invited Huang Lei, Director of the Public Health Department of the National Health and Health Commission, and Zhang Chaoyang, President of the China Rural Health Association to attend and deliver speeches online.
Academicians Jia Weiping and Professor Cai Chun of the National Grassroots Diabetes Prevention and Management Office, and Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine Prof.
Li Hong and Prof.
Pan Jiemin from Shanghai Sixth People's Hospital were the speakers, respectively interpreting the main points of the new version of the "Guide", the research on the improvement of blood sugar fluctuations in the treatment of type 2 diabetes with traditional Chinese medicine, the health management of diabetes at the grassroots level, and the treatment drugs for diabetes, etc.
and share
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‍At the key point interpretation meeting of the new version of the "Guidelines" for comprehensive prevention and control, Academician Jia Weiping of the Chinese Academy of Engineering first introduced the revision background, basis and main content of the new version of the "Guidelines"
.

In terms of diabetes treatment, Academician Jia Weiping introduced the following update points
.

Life>
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The new version of the "Guidelines" adds the principles and key points of a reasonable diet, including controlling total calories and energy balance; increasing the recommendation of resistance exercise; diabetic patients should abstain from alcohol; salt intake is limited to less than 5g per day
.

hypoglycemic treatment
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The new version of the "Guidelines" points out that individualized blood sugar control goals should be emphasized; the hypoglycemic treatment path should comprehensively consider the current allocation and use of basic diabetes drugs in primary medical institutions
.

Antihypertensive, lipid-lowering, and antiplatelet therapy
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The new version of the "Guidelines" emphasizes that elderly hypertensive patients with ischemic heart disease should pay attention to diastolic blood pressure while emphasizing that systolic blood pressure reaches the standard, and diastolic blood pressure should not be lower than 60 mmHg; it emphasizes reducing low-density lipoprotein cholesterol (LDL-C) The importance of aspirin and its primary goal of lipid-lowering therapy; the recommendation of aspirin for primary prevention of cardiovascular disease in diabetic patients is deleted, and its important role in secondary prevention is emphasized, and bleeding should be fully assessed during application.
risk
.

Recognition and management of hypoglycemia
.

The new edition of the "Guidelines" defines that patients with diabetes belong to the category of hypoglycemia as long as the blood glucose level is less than 3.
9mmol/L; the guideline supplements the common causes, typical symptoms and prevention strategies of hypoglycemia
.

Diabetes chronic complications examination
.

The new version of the "Guidelines" emphasizes the importance of urine albumin/creatinine ratio (UACR) examination.
It is recommended to perform UACR examination at least once a year, and those who are unable to carry out should be transferred to a higher-level hospital for examination; qualified institutions should carry out diabetic retinopathy at least once a year.
Check
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Chinese medicine prevention and treatment of diabetes
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The new edition of the Guidelines includes more Chinese medicines with evidence-based medicine that can synergistically treat diabetes and its complications, and actively supports and encourages the integration of Chinese medicine into the comprehensive diabetes prevention and control system
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The guidelines make it clear that in terms of synergistic sugar control and symptom improvement, it is recommended that patients with type 2 diabetes can use Jinlida granules in combination on the basis of conventional treatment
.

‍Chinese and Western synergy to help grassroots diabetes management In terms of Chinese medicine synergistically lowering blood sugar and improving symptoms, Professor Pan Jiemin introduced an evidence-based medical study led by Academician Tong Xiaolin, including a total of 192 cases of metformin stable dose treatment for 3 months with poor blood sugar control.
best type 2 diabetes patients
.

The results showed that the addition of Jinlida granules on the basis of metformin could further reduce the glycosylated hemoglobin (HbA1c) by 0.
92%, significantly improve the islet β-cell function index, reduce the fasting blood sugar and 2-hour postprandial blood sugar, and improve thirst, fatigue and constipation.
and other symptoms [1]
.

In recent years, a large number of studies have confirmed that large blood sugar fluctuations are closely related to diabetes complications
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Therefore, blood glucose fluctuation is a new target for diabetes treatment
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In response to the improvement of blood sugar fluctuations by traditional Chinese medicine, Professor Pan Jiemin introduced a clinical study on the effect of Jinlida granules on blood sugar fluctuations in patients with type 2 diabetes led by Academician Jia Weiping.
The results showed that Jinlida granules could significantly improve the glucose metabolism (HbA1c, fasting blood sugar, postprandial blood sugar) and TCM symptom score
.

Compared with the control group, the standard deviation of blood glucose level in Jinlida granule group was significantly decreased after treatment (-0.
39 vs.
0.
11, P<0.
01), and the time within the blood glucose target range (TIR) ​​was significantly improved after treatment (23.
21%).
vs.
2.
24%, P < 0.
01)
.

This indicates that Jinlida Granules can improve blood sugar control and blood sugar fluctuation in newly diagnosed type 2 diabetes patients[2]
.

Academician Jia Weiping pointed out that a number of medical studies have confirmed the efficacy of Jinlida Granules in preventing and treating diabetes
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Based on solid evidence, Jinlida granules are listed as recommended drugs in many diabetes prevention and treatment guidelines, including the 2017 and 2020 editions of the "China Guidelines for the Prevention and Treatment of Type 2 Diabetes" and the English version of the "Chinese Standards for the Treatment of Type 2 Diabetes" released in 2019
.

Academician Jia Weiping emphasized that the release of the English version of the guidelines also made the Chinese medicine treatment of diabetes go international
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‍Basic requirements for a sound system of diabetes management Doing a good job in diabetes management is crucial to delaying the progression of diabetes, reducing the risk of diabetes complications, and reducing diabetes-related medical expenses
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As the main battlefield of diabetes management, primary medical and health institutions have arduous tasks
.

Professor Cai Chun introduced that primary medical units should set up a diabetes management team, configure basic equipment and basic security drugs for diabetes management, and provide patients with comprehensive, continuous, responsible, medical-prevention integrated health management combined with the family doctor's contracted service system.
service
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In terms of basic security drugs, Professor Cai introduced that primary medical and health institutions should be equipped with five basic hypoglycemic drugs: metformin, insulin secretagogues, α-glucosidase inhibitors, thiazolidinediones (TZDs) and insulin
.

Qualified primary medical institutions can be further equipped with dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium-glucose co-transporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) inhibitors ) receptor agonists
.

At the same time, grass-roots health institutions should also establish a cooperation mechanism with higher-level hospitals to achieve two-way referral
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If primary physicians encounter difficulties in diagnosis, special patients, difficult treatment and serious complications in the process of diagnosis and treatment, they must be transferred to secondary or higher hospitals in time
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The specific referral criteria are as follows: ‍Focus on the role and contraindications of commonly used hypoglycemic drugs.
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If the simple life>
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Regarding the precautions for common hypoglycemic drug treatment, Professor Li Hong pointed out that before drug treatment, read the drug instructions carefully and exclude contraindications according to the drug instructions; different types of drugs can be used in combination, and the same type of drugs should be avoided at the same time; When hypoglycemic drugs are used, hypoglycemia warning education should be carried out, especially for patients who use insulin secretagogues and insulin; blood glucose monitoring should be carried out in the use of hypoglycemic drugs, especially for patients receiving insulin therapy; patients’ economics should be considered when choosing drugs competency and patient compliance
.

In view of the pharmacological effects, adverse reactions and contraindications of different hypoglycemic drugs, Professor Li Hong made the following introduction
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‍It is understood that more than 100,000 online learning sessions of the new edition of the "Guidelines" training session have been conducted, and the content has been widely praised by grassroots medical staff
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The "Healthy China, Empowering County" campaign is a national public welfare project in the industry to improve the diagnosis and treatment level of grassroots health personnel and general practitioners in county and urban communities.
It is committed to continuously strengthening continuing education for medical professionals and comprehensively improving the level of grassroots diagnosis and treatment
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The "Healthy China, Empowering County" campaign continues to focus on the chronic disease areas with a large number of grassroots patients, and provides more help for grassroots talents through training content close to the grassroots.
Come on for the development of a healthy China
.

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