{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T13:31:15Z","timestamp":1756992675681,"version":"3.37.3"},"reference-count":19,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,28]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Worldwide, an estimated 40\u2009million people are in need of palliative care each year, but only 14% receive it. The incidence of diabetes mellitus (DM) in patients receiving palliative care is higher than in the general population. This association is intended to grow as a result of the rising burden of DM worldwide, ageing populations and the improved overall survival time of several diseases over the last few decades. Recommendations for DM management in the context of palliative care are mainly based on expert opinion as there is a lack of suitable evidence base and randomised clinical trials in palliative care are scarce. The aim of our systematic review is to identify the best DM management practices in order to reduce important DM-related symptoms and acute complications in patients receiving palliative care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>The authors will study the DM treatment and management literature, surveying the different approaches employed to treat adult palliative patients. Core health bibliographic databases will be searched from January 1990 to May 2019. Data sources will include Ovid MEDLINE, Embase, PubMed, Web of Sciences, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature and grey literature. Details regarding diet, oral and injectable glucose-lowering medicines, insulin regimens and blood glucose monitoring strategies will be evaluated. We defined the primary outcomes to compare between DM management approaches as the presence of symptoms (polyuria, polydipsia and polyphagia) and acute complications of DM (hypoglycaemia, hyperglycaemic hyperosmolar state and diabetic ketoacidosis), and secondary outcomes as hospital admissions and deaths due to DM-related complications, health-related quality of life and glycaemic control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>The systematic review methodology does not require ethics approval due to the nature of the study design. The results of the systematic review will be published in a peer-reviewed journal and will be publicly available.<\/jats:p><\/jats:sec><jats:sec><jats:title>PROSPERO registration number<\/jats:title><jats:p>CRD42018115772.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028604","type":"journal-article","created":{"date-parts":[[2019,6,15]],"date-time":"2019-06-15T10:04:10Z","timestamp":1560593050000},"page":"e028604","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Diabetes-related symptoms, acute complications and management of diabetes mellitus of patients who are receiving palliative care: a protocol for a systematic review"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7217-0509","authenticated-orcid":false,"given":"Rita","family":"Bettencourt-Silva","sequence":"first","affiliation":[]},{"given":"Beatriz","family":"Aguiar","sequence":"additional","affiliation":[]},{"given":"V\u00e2nia","family":"S\u00e1-Ara\u00fajo","sequence":"additional","affiliation":[]},{"given":"Rosa","family":"Barreira","sequence":"additional","affiliation":[]},{"given":"V\u00e2nia","family":"Guedes","sequence":"additional","affiliation":[]},{"given":"Maria Jo\u00e3o","family":"Marques Ribeiro","sequence":"additional","affiliation":[]},{"given":"Davide","family":"Carvalho","sequence":"additional","affiliation":[]},{"given":"Linda","family":"\u00d6stlundh","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6982-8063","authenticated-orcid":false,"given":"Mar\u00edlia Silva","family":"Paulo","sequence":"additional","affiliation":[]}],"member":"239","published-online":{"date-parts":[[2019,6,14]]},"reference":[{"key":"2024052012533838000_9.6.e028604.1","unstructured":"World Health Organization. WHO | WHO Definition of Palliative Care. WHO. 2012 http:\/\/www.who.int\/cancer\/palliative\/definition\/en\/ (accessed 14 Nov 2018)."},{"key":"2024052012533838000_9.6.e028604.2","unstructured":"World Health Organization. Palliative Care: symptom management and end-of-life care. Integrated Management of Adolescents and Adult Illness - Interim Guidelines for first level facilityhealth workers. 2004 https:\/\/www.who.int\/3by5\/publications\/documents\/en\/genericpalliativecare082004.pdf (accessed 10 Mar 2019)."},{"key":"2024052012533838000_9.6.e028604.3","unstructured":"World Health Organization. WHO Fact Sheets on Palliative Care. http:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care (accessed 14 Nov 2018)."},{"key":"2024052012533838000_9.6.e028604.4","unstructured":"Surveillance Research Program NCI. SEER*Explorer: An interactive website for SEER cancer statistics. https:\/\/seer.cancer.gov\/explorer\/ (accessed 14 Nov 2018)."},{"key":"2024052012533838000_9.6.e028604.5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jcjd.2014.01.009","article-title":"Identifying persons with diabetes who could benefit from a palliative approach to care","volume":"39","author":"Johnston","year":"2015","journal-title":"Can J Diabetes"},{"key":"2024052012533838000_9.6.e028604.6","unstructured":"The World Hospice Palliative Care Association. WHO Global Atlas on Palliative Care At the End of Life. http:\/\/www.thewhpca.org\/resources\/global-atlas-on-end-of-life-care (accessed 14 Nov 2018)."},{"key":"2024052012533838000_9.6.e028604.7","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.diabres.2017.09.018","article-title":"Palliative and end of life care of people with diabetes: Issues, challenges and strategies","volume":"143","author":"Dunning","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"key":"2024052012533838000_9.6.e028604.8","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S012"},{"key":"2024052012533838000_9.6.e028604.9","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.diabres.2014.03.005","article-title":"New IDF Guideline for managing type 2 diabetes in older people","volume":"103","author":"Dunning","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"2024052012533838000_9.6.e028604.10","doi-asserted-by":"publisher","DOI":"10.2337\/dci18-0033"},{"key":"2024052012533838000_9.6.e028604.11","doi-asserted-by":"crossref","first-page":"91","DOI":"10.4158\/CS-2017-0153","article-title":"COnsensus statement by the american association of clinical endocrinologists and american college of endocrinology on the comprehensive type 2 diabetes management algorithm - 2018 executive summary","volume":"24","author":"Garber","year":"2018","journal-title":"Endocr Pract"},{"key":"2024052012533838000_9.6.e028604.12","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.diabres.2017.12.010","article-title":"Managing people with diabetes during the cancer palliation in the era of simultaneous care","volume":"143","author":"Ferrari","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"key":"2024052012533838000_9.6.e028604.13","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-S006"},{"key":"2024052012533838000_9.6.e028604.14","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.diabres.2018.02.044","article-title":"Diabetologists and Oncologists attitudes towards treating diabetes in the oncologic patient: Insights from an exploratory survey","volume":"143","author":"Clemente","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"key":"2024052012533838000_9.6.e028604.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647"},{"key":"2024052012533838000_9.6.e028604.16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"2024052012533838000_9.6.e028604.17","doi-asserted-by":"crossref","first-page":"68","DOI":"10.5596\/c14-016","article-title":"Product Review: Covidence (Systematic Review Software)","volume":"35","author":"Babineau","year":"2014","journal-title":"J Can Heal Libr Assoc \/ J l\u2019Association des biblioth\u00e8ques la sant\u00e9 du Canada"},{"key":"2024052012533838000_9.6.e028604.18","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2098"},{"key":"2024052012533838000_9.6.e028604.19","unstructured":"National Heart Lung and Blood Institute. Study Quality Assessment Tools - NHLBI, NIH. 2016 https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools (accessed 21 Nov 2018)."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-028604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T20:06:05Z","timestamp":1716235565000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-028604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":19,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,14]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bmjopen-2018-028604"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-028604","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}