Standards of Practice on Diabetes

Standards of Practice on Diabetes

Print & Use to Rapidly Critically Appraise Evidence-Based Clinical Practice Guidelines

CREDIBILITY

Who were the guideline developers? American Diabetes Association

Were the developers representative of key stakeholders in this specialty (interdisciplinary)? National Standards

Who funded the guideline development? ADA

Were any of the guideline developers funded researchers of the reviewed studies? No, National Association.

Did the team have a valid development strategy? Yes, effective overview of significant symptoms and treatment factors.

Was an explicit (how decisions were made), sensible and impartial process used to identify, select, and combine evidence? Yes No

Did its developers carry out a comprehensive, reproducible literature review within the past 12 months of its publication/revision? Yes No -- Continual and updated information published in both peer reviewed and speciality publications.

Were all important options and outcomes considered? While not a complete tome (books have been written about small aspects), this is comprehensive overview of the issue.

9) Is each recommendation in the guideline tagged by the level/strength of evidence upon which it is based and linked with the scientific evidence? All based on peer viewed research and medical documentation.

10) Do the guidelines make explicit recommendations (reflecting value judgments about outcomes)? Treatment guidelines and efficacy of mitigating factors shown.

11) Has the guideline been subjected to peer review and testing? APPLICABILITY/GENERALIZABILITY

12) Is the intent of use provided (e.g. national, regional, local)? Actually international; all patients, all cultures.

13) Are the recommendations clinically relevant? Yes, clinically relevant and updated.

14) Will the recommendations help me in caring for my patients? Yes, understanding this document would be a superior way to understand the issue.

15) Are the recommendations practical/feasible (e. g. resources [people and equipment] available)? This is highly dependent upon the organization and institution in question. In general, the care paradigm provided is doable for even many small clinics. The documentation is valid for all sizes of population as well as giving patient responsibility for their health care rules.

16) Are the recommendations a major variation from current practice? The American Diabetes Association is over 70 years old and has been working to fight the consequences of the disease since 1941. Besides their obvious fund-raising commitment, they have recently increased their support for diabetes to almost $43million (http://www.diabetes.org/news-research/research/).

17) Can the outcomes be measured through standard care? Yes, qualitative and quantitative measurements are standard and needed based on the increasing number of Type II diabetes patients. This increase is primarily cultural, and due to obesity and an unhealthy diet.

One of the more serious aspects of type II diabetes is the new prevalence of onset during later teen years, most likely completely due to rising obesity patterns in children. Symptoms for both children and adults range from chronic fatigue, general weakness and malaise to excessive thirst, blurred vision, lethargy, and more serious internal dysfunction. There also appears to be a strong connection in type II diabetes to a genetic predisposition -- which is ironically a similar predisposition to hypertension, cholesterol issues and obesity. Clearly, the epidemic proportions of the disease have increased due to a rapidly aging population, high-fat diets, and a far less active lifestyle (Zimmer, 2002).