Global Guideline for Type 2 Diabetes

Global Guideline for Type 2 Global Guideline for Type 2 DiabetesDiabetes

Global Guideline for Type 2 Global Guideline for Type 2 DiabetesDiabetes

Global Guideline for Type 2 Diabetes

Welcome and Introduction

Professor Philip Home

Chair IDF Task Force on Clinical GuidelinesCo-chair IDF Guideline Development Group

Welcome and Introduction

Professor Philip Home

Chair IDF Task Force on Clinical GuidelinesCo-chair IDF Guideline Development Group

Global Guideline for Type 2 Diabetes

The extent of the problem

• Growing number of people with diabetes• Over 3 000 000 deaths are attributable

to diabetes each year*

• Growing number of people with diabetes• Over 3 000 000 deaths are attributable

to diabetes each year*

(*)Ref: Diabetes Action Now, IDF-WHO 2004

Global projection for the diabetes epidemic: 2003-2025 (millions)

23.0 36.257%

23.0 36.257%

14.226.285%

14.226.285%

48.458.621%

48.458.621%

43.075.876%

43.075.876% 7.1

15.0111%

7.1 15.0111%

World2003 = 194 million = 5.1% of adult population2025 = 333 million= 6.3% of adult populationIncrease 72%

39.381.6108%

39.381.6108%

19.239.4105%

19.239.4105%

Ref: Diabetes Atlas second edition, IDF 2003

Global Guideline for Type 2 Diabetes

The extent of the problem

Optimal diabetes management is not reaching many – perhaps the majority of – people with diabetes

Reflects :• Size and complexity of the evidence

base• Complexity of diabetes care itself

Optimal diabetes management is not reaching many – perhaps the majority of – people with diabetes

Reflects :• Size and complexity of the evidence

base• Complexity of diabetes care itself

Global Guideline for Type 2 Diabetes

Consequences

Results :• Lack of proven cost-effective resources

for diabetes care• Diversity of standards of clinical practice

Results :• Lack of proven cost-effective resources

for diabetes care• Diversity of standards of clinical practice

Global Guideline for Type 2 Diabetes

A global guideline A unique challenge

Challenge :• Addressing different groups of people in

various health-care systems and levels of resources

‘Levels of care’ approach

Challenge :• Addressing different groups of people in

various health-care systems and levels of resources

‘Levels of care’ approach

Global Guideline for Type 2 Diabetes

Objective of the guideline

• To promote the implementation of diabetes care that is:• cost-effective • evidence based • applicable in all settings, whatever the

resources available

• To promote the implementation of diabetes care that is:• cost-effective • evidence based • applicable in all settings, whatever the

resources available

Global Guideline for Type 2 Diabetes

First global evidence-based guideline

• Based on published national evidence-based reviews and guidelines from the last 5 years

• Reference to recent publications relevant to a specific section

• Reference to meta-analyses

• Based on published national evidence-based reviews and guidelines from the last 5 years

• Reference to recent publications relevant to a specific section

• Reference to meta-analyses

Global Guideline for Type 2 Diabetes

Global input

• Process involved:• Health-care professionals from diverse

disciplines• People with diabetes• People from NGOs

• Input from • People from all IDF Regions• Countries in very different states of economic

development

• Process involved:• Health-care professionals from diverse

disciplines• People with diabetes• People from NGOs

• Input from • People from all IDF Regions• Countries in very different states of economic

development

Global Guideline for Type 2 Diabetes

Levels of Care

Professor Stephen Colagiuri Co-Chair IDF Task Force on Clinical Guidelines

Levels of Care

Professor Stephen Colagiuri Co-Chair IDF Task Force on Clinical Guidelines

Global Guideline for Type 2 Diabetes

Levels of Care Approach

Standard Care Minimal Care Comprehensive Care

Global Guideline for Type 2 Diabetes

Example : foot care

Standard care

FT1 Assess feet of people with diabetes as part of an annual review:

Global Guideline for Type 2 Diabetes

Example : foot care

Global Guideline for Type 2 Diabetes

Example : foot care

FT5 Manage according to classification level:

Global Guideline for Type 2 Diabetes

Example : foot care

Global Guideline for Type 2 Diabetes

Glucose control levels

Standard care

TT1 Advise people with diabetes that maintaining a DCCT-aligned HbA1c below 6.5% should minimize their risk of developing complications

Global Guideline for Type 2 Diabetes

Glucose control levels

Minimal care

TTm1 The intervention levels are as for Standard care, but may need to be based on measurement of plasma glucose levels alone