New Global Guideline for Type 2 Diabetes Calls for More Aggressive Treatment

The first Global Guidelines for Type 2 Diabetes were issued by the International Diabetes Federation (IDF), and they call for a more aggressive treatment target than the American Diabetes Association guidelines’ goal.

The IDF Guidelines, presented at the European Association for the Study of Diabetes meeting here, recommend maintaining glycosylated blood glucose levels (HbA1c) below 6.5%.

An IDF official said the guidelines are supposed to apply globally, but Richard Kahn, Ph.D., chief scientific and medical officer of the American Diabetes Association, said, "The ADA has its own clinical practice guidelines, and those are what we urge people to follow. Our goal is HbA1c of less than 7%."

By lowering the blood glucose target, the IDF is setting the treatment bar high since two-thirds of diabetics in Europe and the U.S. are not achieving this HbA1c target. Eugene Hughes, M.D., chairman of Primary Care Diabetes Europe, called the new HbA1c goal "a daunting standard that we will try to achieve."

The IDF guidelines include recommendations on patient education, self-monitoring of glucose levels by patients, and active use of oral agents and insulin to obtain target glucose levels. It also identifies cost-effective methods for early identification of eye, renal, and foot problems in diabetics.

IDF, which is an umbrella organization of associations from 150 countries, including the United States, is taking an unusual approach with this guideline. Rather than setting one standard, and expecting poor countries to have the same resources as richer countries, it has established three levels of care that can be applied, depending on the health care resources available in a country.

Stephen Colagiuri, M.D., a professor of medicine at the University of New South Wales in Australia, who co-chairs the IDF Task Force on Clinical Guidelines called the new guidelines "globally applicable as it is sensitive to resource and cost-effectiveness."

The three approaches are:
· Comprehensive care includes the most up-to-date and complete range of health technologies available, regardless of the quality of the evidence supporting their use.
· Standard care is evidence-based care that is cost-effective in most countries with a well-developed health care system and national health-care funding systems. The guidelines say this level of care should be available to every diabetic, and this level of care should be the aim of every health care system.
· Minimal care is the lowest level of care that anyone with diabetes should receive. It seeks to achieve the major goals of diabetes management, but it is provided in poorly funded healthcare settings, where medical resources and fully trained health care professionals are unavailable. Only low-cost or very cost-effective interventions are included at this level.
The American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE) applaud the International Diabetes Federation (IDF) for formally endorsing an A1C standard of below 6.5 percent, at the European Association for the Study of Diabetes (EASD) meeting Tuesday.

=============================

The 10,000 STEP STUDY:
"The Results". A simple answer to a difficult problem.
https://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=2001

Our advertisers keep this newsletter free, help by updating your profile!!!
https://www.diabetesincontrol.com/surveys/index.php