Global Guideline for Type 2 Diabetes

1. Global Guideline for Type 2 Diabetes

2. Welcome and Introduction Professor Philip Home Chair IDF Task Force on Clinical Guidelines Co-chair IDF Guideline Development Group

3. The extent of the problem • Growing number of people with diabetes • Over 3 000000 deaths are attributable to diabetes each year* (*)Ref: Diabetes Action Now, IDF-WHO 2004

4. Global projection for the diabetes epidemic: 2003-2025 (millions) 48.4 58.6 21% 39.3 81.6 108% 23.0 36.2 57% 43.0 75.8 76% 19.2 39.4 105% 14.2 26.2 85% 7.1 15.0 111% World 2003 = 194 million = 5.1% of adult population 2025 = 333 million = 6.3% of adult population Increase 72% Ref:Diabetes Atlas second edition, IDF 2003

5. 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

6. Consequences Results : • Lack of proven cost-effective resources for diabetes care • Diversity of standards of clinical practice

7. 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

8. 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

9. 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

10. 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

11. Levels of Care Professor Stephen Colagiuri Co-Chair IDF Task Force on Clinical Guidelines

12. Minimal Care Comprehensive Care Levels of Care Approach Standard Care

13. Example : foot care • Standard care • FT1 Assess feet of people with diabetes as part of an annual review:

14. Example : foot care

15. Example : foot care FT5 Manage according to classification level:

16. Example : foot care

17. 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

18. 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