Global Guideline for Type 2 Diabetes

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

Global Guideline for Type 2 Diabetes The extent of the problem Growing number of people with diabetes Over deaths are attributable to diabetes each year* Growing number of people with diabetes Over deaths are attributable to diabetes each year* (*)Ref: Diabetes Action Now, IDF-WHO 2004

Global projection for the diabetes epidemic: (millions) % % % % % % % % % % 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

Global Guideline for Type 2 Diabetes 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 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

Global Guideline for Type 2 Diabetes Consequences Results : Lack of proven cost-effective resources for diabetes care Diversity of standards of clinical practice Results : Lack of proven cost-effective resources for diabetes care Diversity of standards of clinical practice

Global Guideline for Type 2 Diabetes 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 Challenge : Addressing different groups of people in various health-care systems and levels of resources  ‘Levels of care’ approach

Global Guideline for Type 2 Diabetes 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 To promote the implementation of diabetes care that is: cost-effective evidence based applicable in all settings, whatever the resources available

Global Guideline for Type 2 Diabetes 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 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

Global Guideline for Type 2 Diabetes 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 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

Global Guideline for Type 2 Diabetes Levels of Care Professor Stephen Colagiuri Co-Chair IDF Task Force on Clinical Guidelines Levels of Care Professor Stephen Colagiuri Co-Chair IDF Task Force on Clinical Guidelines

Global Guideline for Type 2 Diabetes Levels of Care Approach Standard Care Minimal Care Comprehensive Care

Global Guideline for Type 2 Diabetes Example : foot care  Standard care FT1 Assess feet of people with diabetes as part of an annual review:

Global Guideline for Type 2 Diabetes Example : foot care

Global Guideline for Type 2 Diabetes Example : foot care FT5Manage according to classification level:

Global Guideline for Type 2 Diabetes Example : foot care

Global Guideline for Type 2 Diabetes 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

Global Guideline for Type 2 Diabetes Glucose control levels  Minimal care TTm1The intervention levels are as for Standard care, but may need to be based on measurement of plasma glucose levels alone