1. Global Guideline for Type 2 Diabetes

2. 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

3. Global Guideline for Type 2 Diabetes The extent of the problem Growing number of people with diabetes Over 3 000 000 deaths are attributable to diabetes each year* Growing number of people with diabetes Over 3 000 000 deaths are attributable to diabetes each year* (*)Ref: Diabetes Action Now, IDF-WHO 2004

4. Global projection for the diabetes epidemic: 2003-2025 (millions) 23.0 36.2 57% 23.0 36.2 57% 14.2 26.2 85% 14.2 26.2 85% 48.4 58.6 21% 48.4 58.6 21% 43.0 75.8 76% 43.0 75.8 76% 7.1 15.0 111% 7.1 15.0 111% World 2003 = 194 million = 5.1% of adult population 2025 = 333 million = 6.3% of adult population Increase 72% 39.3 81.6 108% 39.3 81.6 108% 19.2 39.4 105% 19.2 39.4 105% Ref: Diabetes Atlas second edition, IDF 2003

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

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

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

14. Global Guideline for Type 2 Diabetes Example : foot care

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

16. Global Guideline for Type 2 Diabetes Example : foot care

17. 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

18. 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