ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1603905
Construction of a Management Protocol for High-Risk Neurogenic Bladder in Chinese Patients with Type 2 Diabetes: A Delphi Study
Provisionally accepted
- 1Department of Nursing, Shenzhen Hospital, Southern Medical University, Shenzhen, China
- 2School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China
- 3Pulmonary and Critical Care Medicine, Fuyong People’s Hospital of Bao’an District, Shenzhen, Guangdong, Shenzhen, China
- 4Department of Urology, Fuyong People’s Hospital of Bao'an District, Shenzhen, China
- 5Department of Nursing, Peking University Shenzhen Hospital, Shenzhen, China
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Objectives: The objective of this study is to establish an evidence-based protocol for managing high-risk neurogenic bladder (NB) in Chinese patients with T2DM, integrating risk stratification to standardize clinical practice in China region. Methods: Through a two-round Delphi consensus process involving 20 national experts and evidence synthesis from 13 clinical guidelines and a systematic review, we developed China's first hierarchical NB risk stratification system. Quantitative analyses incorporated authority weighting (0–1 scale), coordination coefficients, and Kendall's concordance testing across 81 systematically validated clinical indicators. Results: High expert engagement persisted through both rounds (Round 1: 90% response rate; Round 2: 94.7%). Consensus levels demonstrated progressive improvement, with primary indicators achieving the most substantial enhancement (Kendall's W: 0.289 vs. 0.391, 35.3% improvement). Secondary and tertiary indicators showed 5.5% and 27.4% increases respectively (all p<0.01). The final protocol reached a consensus, including 4 primary indicators, 17 secondary indicators, and 60 tertiary indicators. Conclusion: This consensus-driven framework provides innovative clinical tools for NB risk stratification in diabetes care. Its three-tiered structure—integrating policy recommendations, clinical algorithms, and bedside assessment protocols—significantly improves patient management and outcomes, serving as a valuable resource to guide clinical practice.
Keywords: neurogenic bladder, type 2 diabetes mellitus, Delphi study, risk stratification, Management protocol
Received: 12 Apr 2025; Accepted: 26 Sep 2025.
Copyright: © 2025 Luo, Ren, Hu, Deng, Lai and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenjuan Lai, grace016085@163.com
Wenzhi Cai, caiwzh@smu.edu.cn
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