IDF WPR Guidelines

PRESS RELEASE
Bangkok, 25 October 2005
Experts warn that complications from diabetes epidemic will cause health budgets to explode in Asia
New Guidelines Encourage Doctors to Rise to Global Treatment Standards
Health budgets across Asia will face crippling cost pressures if the current level of treatment does not improve to conquer the diabetes epidemic, according to experts here at the International Diabetes Federation Western Pacific Region (IDF WPR) Congress.  New treatment guidelines presented here have sparked debate about the best way to measure how Asians with diabetes are responding to treatment that would allow them to reduce risks for serious complications.
Diabetes is often referred to as the “silent killer.”  The IDF estimates that 330 million people worldwide will have diabetes by 2025, and more than 60 percent of those affected will be in Asia Pacific.  Most alarmingly, there is a growing trend of more children being diagnosed with type 2 diabetes (formerly only seen in adults), which will put them at risk of health problems as adults in the workforce.  A recent study showed that, because so many people with diabetes in Asia are not treated adequately, more than 80 percent are now at a greatly increased risk for suffering a stroke or heart attack1.
“Diabetes is a serious, debilitating disease.  If it is not managed, the consequences can impact the whole family, not just the person with the disease,” said Professor Paul Zimmet, Director of the International Diabetes Institute in Melbourne, Australia.  “It is frightening to think of how many people with diabetes in Asia are not being routinely measured for their HbA1c, which is the best test to measure how well the treatment is working.  The good news is that, if monitored accurately, anyone with diabetes can have the chance to help control their own destiny by making necessary lifestyle changes.  The new guidelines are also tailored to be relevant to the Asian region’s dietary and other lifestyle practices.”
The “gold standard” diabetes test
The fourth edition of the IDF WPR’s Type 2 Diabetes Practical Targets and Treatment guidelines – used by diabetes experts, general practitioners and health professionals as a reference point for how they manage diabetes – includes the strictest treatment targets ever to be proposed in Asia.  Just as the risk of stroke is monitored by regularly checking blood pressure, all global guidelines insist that the risk of diabetes complications must be monitored using a test known as HbA1c, which measures long-term glycaemic control.  In simple terms, a daily blood glucose reading is like taking a daily quiz, while an HbA1c result is similar to a final exam because it is an average score over several months.
Because daily glucose can easily fluctuate depending on an individual’s diet or exercise patterns, daily readings are not considered to be as reliable as HbA1c. If the HbA1c is too high, treatment must be modified appropriately to decrease the risk of stroke, heart disease, kidney failure, blindness and amputations.  Unfortunately, many doctors in Asia still opt for the less reliable daily monitoring, leaving many people with diabetes unknowingly exposed to serious health risks.  Today, two thirds of those affected in Asia are at risk of serious complications due to uncontrolled blood sugar.
“We need people with diabetes to be part of the team that is actively involved with their treatment,” said Professor Clive Cockram, Professor of Medicine at the Chinese University, Hong Kong, and Vice President of the International Diabetes Federation.  “The new guidelines for our region highlight the need for people with diabetes to be informed about their condition, including treatment targets, testing methods and their risk for complications.  We need to improve this in Asia, because informed patients can help contain this potential epidemic.”
Korea and Taiwan are following the global trend of updating diabetes management guidelines to aspire to more aggressive treatment targets, and will announce new national updates later this year.
Download the IDF WPR Type 2 Diabetes Practical Targets and Treatment guidelines (pdf, 720KB).
References:
1. L.-M. Chuang, S.T. Tsai, B.Y. Huang and T.Y. Tai on behalf of the Diabcare-Asia 1998 Study Group. The status of diabetes control in Asia – a cross sectional survey of 24,317 patients with diabetes mellitus in 1998. Diabetic Medicine 2002: 19: 978-985.