Guidelines for Diabetes

Clinical guidelines can be broad and cover all aspects of diabetes care, or can be limited to a particular area, such as screening for retinopathy. Many guidelines have been produced, but not all are soundly based on critically appraised evidence. Ideally, guidelines should be based on systematic reviews. (See section on what a systematic review is.) Not all are, so be aware that guidelines vary in quality. We give details below on how to find good quality guidelines. Clinical practice guidelines (CPGs) are defined by the Institute of Medicine as “statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options”. Rather than dictating a one-size-fits-all approach to patient care, CPGs should aid clinician and patient decision making by clearly describing and appraising the evidence and reasoning regarding the likely benefits and harms related to specific clinical recommendations.

Finding guidelines

Below is a list of sites that contain diabetes guidelines. Guidelines can also be accessed via a PubMed search (see PubMed searches)

  • The National Guidelines Clearing House (NGC) is a database of evidence-based clinical practice guidelines and related documents. It is maintained as a public resource by the Agency for Healthcare Research and Quality (AHRQ) in the U.S. The site can be searched using a simple or advanced search, or guidelines can be browsed by topic. The site also features NGC Guideline Syntheses, which provide a comparison of guidelines developed in different countries.

  • The European Association for the Study of Diabetes (EASD) was founded in Italy in 1965. It aims to encourage and support research in the field of diabetes, the rapid diffusion of acquired knowledge and to facilitate its application. EASD have produced several guidelines and formal statements.

  • The International Diabetes Federation (IDF) is an umbrella organization of over 200 national diabetes associations in over 160 countries. They have produced a number of Clinical Practice Guidelines.

  • The International Society for Pediatric and Adolescent Diabetes (ISPAD) is a professional organization whose aims are to promote clinical and basic science, research, education and advocacy in childhood and adolescent diabetes. They have published the ISPAD Clinical Practice Consensus Guidelines 2009.

  • The American Diabetes Association (ADA) is a United States-based association working to fight the consequences of diabetes and to help those affected by diabetes. Its Clinical Practice Recommendations are based on a complete review of the relevant literature by a diverse group of highly trained clinicians and researchers.

  • The National Institute for Health and Care Excellence (NICE) is a non-departmental public body of the Department of Health in the United Kingdom. It provides independent, authoritative and evidence-based guidance to supports healthcare professionals and others. They have a list of Guidance on diabetes and related topics. These include Clinical guidelines and other forms of guidance. The clinical guidelines cover all aspects of care. There are separate guidelines for type 1 and type 2 diabetes, and for pregnancy in diabetes. The other forms of guidance include technology appraisals, usually of the clinical and cost-effectiveness of single treatments, and public health guidance, for example on prevention of diabetes. Each piece of guidance is supported by separate summaries of evidence.

  • Diabetes Australia is a national body supporting people with diabetes and those professional and research bodies concerned with the treatment and prevention of diabetes. It produces Best Practice Guidelines for Health Professionals.

  • The Canadian Diabetes Association helps provide patient-centred diabetes care and chronic disease management. It produces Clinical Practice Guidelines.

  • The Scottish Intercollegiate Guidelines Network (SIGN) develops evidence based clinical practice guidelines for a range of topics, including diabetes, for the National Health Service (NHS) in Scotland.

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