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.

To comprehensively retrieve and analyze evidence about the management of nail disease in diabetes, and give a summary of the best evidence.

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.

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.

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.

及时识别和正确处理甲病，对糖尿病患者足溃疡的预防意义重大，但目前临床医务人员对糖尿病患者甲病的认识普遍不足，而我国尚缺乏有关糖尿病患者甲病管理的循证依据。

全面检索和分析糖尿病患者甲病管理相关证据，并对最佳证据进行总结。

检索2021-12-06前在BMJ Best Practice、UpToDate、世界卫生组织网站、国际指南协作网、英国国家卫生与临床优化研究所网站、美国国立指南库、加拿大安大略护士学会、苏格兰学院间指南网、新西兰指南协作网、医脉通、JBI循证卫生保健中心、PubMed、Embase、CINAHL、中国知网、万方数据知识服务平台中与糖尿病患者甲病管理相关的临床决策、指南、系统评价、专家共识，对其进行质量评价，依据JBI循证卫生保健中心证据预分级系统（2016版）进行证据分级，对最佳证据进行汇总。

共纳入文献8篇，包括临床决策1篇、指南4篇、专家共识3篇。1篇临床决策来自UpToDate直接纳入；4篇指南中2篇质量评价为B级，2篇为A级，均纳入；3篇专家共识的质量评价结果均为准予纳入。最终围绕评估内容、处理方式、健康教育3个方面共汇总9条最佳证据，其中5条证据为A级推荐，4条为B级推荐。

本研究检索了糖尿病患者甲病管理相关的临床决策、指南及专家共识，通过分析总结了糖尿病患者甲病管理的最佳证据，涉及评估内容、处理方式、健康教育3个方面，证据等级为A级推荐和B级推荐，可为医务人员针对糖尿病患者进行甲病的早期评估与处理提供循证证据。