Global Guideline for Type 2 Diabetes
Global Guideline for Type 2 Diabetes
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DOI：
10.1016/j.diabres.2012.10.001
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发表时间：
2014-04-01
影响因子：
5.1
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中科院分区：
文献类型：
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现在有大量证据表明糖尿病的最佳管理，为改善糖尿病患者的短期和长期生活质量提供了机会。不幸的是，这种最佳管理并没有惠及许多人，也许是大多数人。原因包括证据基础的规模和复杂性，以及糖尿病护理本身的复杂性。结果之一是缺乏经证明具有成本效益的糖尿病护理资源。另一个结果是临床实践标准的多样性。准则是设法解决这些问题的进程的一部分。近年来，许多指南在国际、国家和地方上出现，但其中大多数都没有使用严格的新指南方法来识别和分析证据。世界上许多国家都没有制定糖尿病指南所需的资源，无论是在专业知识还是财政方面。此外，这种重复的方法将是非常低效和昂贵的。公布的国家准则来自资源相对丰富的国家，在资源较少的国家可能实际用途有限。2005年，第一个IDF全球2型糖尿病指南制定。在我们试图制定一项对资源和成本效益问题敏感的准则时，这提出了一个独特的挑战。许多国家的指导方针在一个保健系统中针对一个糖尿病患者群体，国家和保健资源水平相同。在全球范围内情况并非如此，虽然每个保健系统似乎都缺乏资源，但各国之间，甚至各地区之间，可用于保健的资金和专门知识差别很大。尽管面临挑战，但我们认为我们找到了一种方法，至少在解决我们称之为“护理水平”的问题方面取得了部分成功（见下一页）。本指南是对第一个指南的更新，并通过纳入自2005年原始指南发布以来出现的新研究和治疗方法来扩展证据基础。资金对于这类活动至关重要。以色列国防军感谢各种商业伙伴提供无限制的教育赠款。
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 diabetes. 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 which 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. Many countries around the world do not have the resources, either in expertise or financially, that are needed to develop diabetes guidelines. Also such a repetitive approach would be enormously inefficient and costly. Published national guidelines come from relatively resource-rich countries, and may be of limited practical use in less well resourced countries. In 2005 the first IDF Global Guideline for Type 2 Diabetes was developed. This presented a unique challenge as we tried to develop a guideline that is sensitive to resource and cost-effectiveness issues. 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, the funding and expertise available for health-care vary widely between countries and even between localities. Despite the challenges, we feel that we found an approach which is at least partially successful in addressing this issue which we termed ‘Levels of care’(see next page). This guideline represents an update of the first guideline and extends the evidence base by including new studies and treatments which have emerged since the original guideline was produced in 2005. Funding is essential to an activity of this kind. IDF is grateful to a diversity of commercial partners for provision of unrestricted educational grants.