NIDDK Updates 'Guiding Principles' for Diabetes, Prediabetes

Miriam E. Tucker

August 23, 2018

The National Diabetes Education Program (NDEP) has revised its "Guiding Principles" for diabetes and prediabetes management.

The document, "Guiding Principles for the Care of People With or at Risk for Diabetes", is now available free online from the NDEP, a federally funded program sponsored by the US Department of Health and Human Services' National Institute of Diabetes and Digestive and Kidney Diseases (NIDKK) and Centers for Disease Control and Prevention.

It is not meant as an official guideline, comprehensive review, or position statement. Rather, it aims to "identify and synthesize areas of general agreement among existing guidelines to help guide primary care providers and health care teams to deliver quality care to adults with or at risk for diabetes."

The previous version of "Guiding Principles" was issued in 2014. The update "reflects new and changing evidence that has evolved over the last several years," including the importance of diabetes self-management education and patient-centered care using shared decision making, as well as a new "principle" addressing obesity management.

"Providing diabetes care can be challenging. While there are strategies that work, there is opportunity to enhance the uptake of proven therapies and prevention of type 2 diabetes. The large health and financial impact of diabetes and the gaps in achievement of treatment and prevention goals prompted the [NDEP] to establish Guiding Principles for the Care of People with or at Risk for Diabetes," the authors say.

The 10 new principles are presented in individual chapters, with detailed clinical information for each one, culled from current guidelines. The principles span the range of topics from identifying patients with undiagnosed diabetes or prediabetes to management of microvascular complications and the needs of special populations.

However, the document focuses primarily on prevention and management of type 2 diabetes in adults, although some of the information is also relevant to type 1 diabetes, gestational diabetes, type 2 diabetes in children, and other forms of the condition.

Professional organizations supporting the document include the American Academy of Family Physicians, American Academy of Physician Assistants, American Association of Clinical Endocrinologists, American Association of Diabetes Educators, American Association of Nurse Practitioners, American College of Obstetricians and Gynecologists, American Diabetes Association, American Geriatrics Society, American Society for Metabolic and Bariatric Surgery, Endocrine Society, National Council of Asian Pacific Islander Physicians, Obesity Medicine Association, and the Obesity Society.

The writing group included a representative of the American College of Physicians, but that organization has not officially endorsed the document. 

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