March 3, 2015

New Non-ADA Diabetes Treatment Guidelines

When I first saw this, I had to wonder why other medical organizations would do this. “The Guiding Principles for the Care of People With or at Risk for Diabetes was produced by the National Diabetes Education Program (NDEP), a federally funded program sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and Centers for Disease Control and Prevention. NDEP’s partnership network includes over 200 partners working together to improve the treatment and outcomes for people with diabetes, promote early diagnosis, and prevent or delay the onset of type 2 diabetes.”

The information article appeared in Diabetes-in-Control and the guidelines are in a PDF file that can be downloaded here. It was a real surprise in the number of medical and other care providers organizations included. I was not disappointment to find the American Diabetes Association and the Academy of Certified Diabetes Educators missing from the list of partners. Admittedly, I was not disappointed in finding a few other medical organizations on the list.

Judith Fradkin, M.D., director of the Division of Diabetes, Endocrinology and Metabolic Diseases in the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health says, "With these Guiding Principles, we aren’t creating new guidelines, but clarifying where there is general agreement across myriad diabetes guidelines. Guiding Principles represents a set of sound practices. Our goal in developing this resource is to help clinicians help their patients with diabetes."

Two of the medical societies endorsing the principles include the American Diabetes Association, the American Association of Clinical Endocrinologists, but they are not partners in the guidelines. From my further reading, yes, this is a government move maybe to force the ADA and AACE into making some changes. Once the government becomes involved in guidelines, we all know that the patients suffer when the government becomes involved.

Medical societies endorsing the principles include the American Diabetes Association, the American Association of Clinical Endocrinologists, the Endocrine Society, the American Geriatrics Society, the American Association of Diabetes Educators, the American College of Obstetricians and Gynecologists, the American Association of Nurse Practitioners, and the American Heart Association. In addition, representatives of the American College of Physicians and the American Academy of Family 
Physicians participated on the writing committee. While these organizations have policies on endorsing guidelines that this document has not fulfilled, they nonetheless have said they plan to promote it.

The 10 principles are:
  1. Identify people with undiagnosed diabetes and prediabetes.
  2. Manage prediabetes to prevent or delay the onset of type 2 diabetes.
  3. Provide ongoing self-management education and support for people with or at risk for diabetes and its complications.
  4. Provide individualized nutrition therapy for people with or at risk for diabetes.
  5. Encourage regular physical activity for people with or at risk for diabetes.
  6. Control blood glucose to prevent or delay the onset of diabetes complications and avert symptoms of hyperglycemia and hypoglycemia.
  7. Provide blood-pressure and cholesterol screening and control, and smoking-cessation and other therapies to reduce cardiovascular disease risk
  8. Provide regular assessments to detect and monitor diabetes microvascular complications and treatments to slow their progression.
  9. Consider the needs of special populations -- children, women of childbearing age, older adults, and high-risk racial and ethnic groups.
  10. Provide patient-centered diabetes care.”

It will be interesting to see how this affects the actions of doctors that are not members of the ADA and other doctors that do not follow the ADA Guidelines.

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