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Global Guideline Sets New Standards for Diabetes Care
Sep 14, 2005, 02:34, Reviewed by: Dr.
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�The guideline is globally applicable as it is sensitive to resource and cost-effectiveness. It adopts a new and innovative approach by advising on three standards of care that can be applied depending on the level of health-care resources available in each country.�
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By International Diabetes Federation,
Today at the European Association for the Study of Diabetes (EASD) congress the International Diabetes Federation (IDF) launches the first ever evidence-based Global Guideline for Type 2 Diabetes. The Guideline calls for a more aggressive approach to the management of type 2 diabetes across the globe, setting new standards for diabetes care to reduce its life-threatening complications. The Guideline was developed by leading diabetes experts from all IDF regions, including representatives from countries in very different states of economic development.
Type 2 diabetes is reaching epidemic proportions across the world. Europe alone counts more than twenty-five million people with diabetes. In most countries, diabetes is now one of the leading causes of death through its effects on cardiovascular disease: 70-80% of people with diabetes die of cardiovascular disease.2 Diabetes is ranked among the leading causes of blindness, renal failure and lower limb amputation with type 2 diabetes accounting for 85-95% of cases of diabetes.2 The total cost of caring for people with diabetes in Europe* is estimated between 28 billion and 53 billion Euros per year.1
As Professor Philip Home, Joint Chair of the IDF Task Force on Clinical Guidelines, explained: �Estimations and projections all concur that the number of people with diabetes which may be reached in the next 25 years would qualify as the largest epidemic humanity has ever experienced. IDF recognizes that immediate action is required and that by sharing evidence-based practice globally we can help alleviate the burden of type 2 diabetes by improving people�s lives and reducing costs to health-care systems. We must ensure all people with type 2 diabetes in Europe and in the world have access to cost-effective evidence-based health-care, and call on immediate action.�
Professor Stephen Colagiuri, Joint Chair of the IDF Task Force on Clinical Guidelines added: �The guideline is globally applicable as it is sensitive to resource and cost-effectiveness. It adopts a new and innovative approach by advising on three standards of care that can be applied depending on the level of health-care resources available in each country.�
The Global Guideline recommends maintaining blood glucose levels (HbA1c) below 6.5% to minimize the risk of complications developing, and supports this with clear recommendations over patient education, self-monitoring of glucose levels by patients, and active use of tablets and insulin to attain target levels. This reflects evidence that despite established benefit of lowering blood glucose (in terms of reducing the risk of complications to the eyes, heart, kidneys and feet)� and evidence that a 1.0 % reduction in HbA1c is associated with a 37% reduction in microvascular complications, two thirds of people with diabetes in Europe are not currently achieving target blood sugar levels. As well as blood glucose, the evidence that blood pressure and blood fat lowering is beneficial in people with diabetes is found to be overwhelming, and appropriate recommendations made for monitoring and treating those modalities are also included.
The Global Guideline also identifies cost-effective methods for identifying problems with eyes, kidney and feet when preventative measures fail; early and proven treatments can then be started.
Eugene Hughes, Chairman of Primary Care Diabetes Europe commented: �The new IDF HbA1c target of 6.5% sets a daunting standard for glycaemic control that we will strive to achieve. We need to embrace the opportunity this Guideline gives us to deliver the best standard of care for all our patients wherever they are in Europe. With proper implementation of the Guideline we have the chance to improve the lives of people with diabetes by reducing complications and achieving a substantial reduction in future health-care costs that unchecked will devour our health-care budgets�. 
- European Association for the Study of Diabetes (EASD) congress the International Diabetes Federation (IDF)
www.idf.org
The International Diabetes Federation (IDF) is an umbrella organization of 190 member associations in 150 countries, representing millions of people with diabetes, their families, and their health-care providers. The mission of the IDF is to promote diabetes care, prevention and a cure worldwide. It does this through education for people with diabetes and health-care professionals, public awareness campaigns and the promotion of the free exchange of diabetes knowledge.
The Global Guideline for Type 2 Diabetes advised on three levels of care:
* Standard care is evidence-based care which is cost-effective in most nations with a well developed service base and national health-care funding systems.
* Minimal care seeks to achieve the major objectives of diabetes management, but is provided in health-care settings with very limited resources.
* Comprehensive care includes the most up-to-date and complete range of health technologies that can be offered to people with diabetes, with the aim of achieving best possible outcome.
* The Global Guideline can be ordered on IDF website (www.idf.org/bookshop) and can be obtained from the IDF stand at the meeting of the European Association for the Study of Diabetes (EASD) in Athens, Greece.
References:
1. Diabetes Atlas second edition, International Diabetes Federation 2003
2. http:/www.eatlas.idf.org/Complications/ Last accessed 1 September 2005
3. UKPDS Study Group. Lancet 1998; 652: 837�853.
4. Stratton IM et al. BMJ 2000; 321: 405�412
5. Liebl L, Mata M, Eschwege E. Evaluation of risk factors for the development of complications in type II diabetes in Europe. Diabetologia 2002; 45: S23-28
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