EPG Diabetes Knowledge Centre
IDF 2005
Preface
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 the condition.
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 evidencebase, 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 that 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 identifi cation and analysis of the evidence.
Increasingly, national organizations have sought to use these new approaches, which are described in the IDF publication Guide for Guidelines. It was noted in that document that many countries around the world do not have the resources, either in expertise or fi nancially, that are needed to promote formal guideline development. In any case, such a repetitive approach would be enormously inefficient.
Accordingly the International Diabetes Federation (IDF) has developed a global guideline. For reasons of efficiency the current initiative has chosen to use the evidence analyses of prior national and local efforts. This should also help to ensure a balance of views and interpretation.
A global guideline presents a unique challenge. 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.
Published national guidelines come from relatively resourcerich countries, and may be of limited practical use in less well resourced countries. Accordingly we have also tried to develop a guideline that is sensitive to resource and costeffectiveness issues. Despite the challenges, we hope to be found to have been at least partially successful in that endeavour, which has used an approach that we have termed ‘Levels of care’.
Funding is essential to an activity of this kind. IDF is grateful to a diversity of commercial partners for provision of unrestricted educational grants.