Global Guideline for Type 2 Diabetes (2005)

There is now extensive evidence on the optimal management of diabetes, offering the opportunity of improving the immediate and long-term quality of life of those with the condition. Unfortunately such optimal management is not reaching many, perhaps the majority, of the people who could benefit.

There is now extensive evidence on the optimal management of diabetes, offering the opportunity of improving the immediate and long-term quality of life of those with the condition. Unfortunately such optimal management is not reaching many, perhaps the majority, of the people who could benefit. Reasons include the size and complexity of the evidence-base, and the complexity of diabetes care itself. One result is a lack of proven cost-effective resources for diabetes care. Another result is diversity of standards of clinical practice.

Guidelines are one part of a process that seeks to address those problems. Many guidelines have appeared internationally, nationally, and more locally in recent years, but most of these have not used the rigorous new guideline methodologies for identification and analysis of the evidence.

Accordingly the International Diabetes Federation (IDF) has developed a global guideline, Global Guideline for Type 2 Diabetes (Brussels: International Diabetes Federation, 2005).

  • Download full document   (560 KB)

A global guideline presents a unique challenge. Many national guidelines address one group of people with diabetes in the context of one health-care system, with one level of national and health-care resources. This is not true in the global context where, although every health-care system seems to be short of resources, and the funding and expertise available for health-care vary widely between countries and even between localities.

Published national guidelines come from relatively resource-rich countries, and may be of limited practical use in less well resourced countries. Accordingly we have also tried to develop a guideline that is sensitive to resource and cost-effectiveness issues.

Levels of care approach

The approach adopted has been to advise on three levels of care: Standard care, Minimal care, and Comprehensive care. Levels of care is a new and innovative concept in diabetes research.

Standard care
Evidence-based care, cost-effective in most nations with a well developed service base and with health-care funding systems consuming a significant part of their national wealth.

Minimal care
Care that seeks to achieve the major objectives of diabetes management, but is provided in health-care settings with very limited resources – drugs, personnel, technologies and procedures.

Comprehensive care
Care with some evidence-base that is provided in health-care settings with considerable resources.

Complete guideline

Sub-sections of the guideline

Global Guideline for Type 2 Diabetes takes into account 19 specific health-care domains and includes topics of importance and controversy. Each section can be downloaded as an separate PDF document (average file size 100KB). The 19 sections are:

Section 1 Screening and diagnosis
Section 2 Care delivery
Section 3 Education
Section 4 Psychological care
Section 5 Lifestyle management
Section 6 Glucose control levels
Section 7 Clinical monitoring
Section 8 Self-monitoring
Section 9 Glucose control: oral therapy
Section 10 Glucose control: insulin therapy
Section 11 Blood pressure control
Section 12 Cardiovascular risk protection
Section 13 Eye screening
Section 14 Kidney damage
Section 15 Foot care
Section 16 Nerve damage
Section 17 Pregnancy
Section 18 Children
Section 19 In-patient care

Acknowledgement

Funding is essential to an activity of this kind. IDF is grateful to a diversity of commercial partners for provision of unrestricted educational grants.

  • Eli Lilly
  • GlaxoSmithKline
  • Merck Inc (MSD)
  • Merck Santé
  • Novo Nordisk
  • Pfizer Inc
  • Roche Diagnostics
  • Sanofi-Aventis
  • Takeda