After scouring the 66 pages of the newly revised Medical Guidelines for Clinical Practice for the Management of Diabetes Mellitus, just released by the American Association of Clinical Endocrinologists (AACE), we want to introduce some of the content.  In contrast to other medical guidelines, this set of diabetes guidelines is refreshingly specific and direct.  It has exact recommendations for patients living with either type 1 or type 2 diabetes.  We want to share some wisdom from this document and recommend some places to start researching.

Patients cannot expect their physicians to communicate all of this information in occasional 15-minute vists.  Furthermore, patients cannot expect doctors to provide detailed explanations of scientific basis of decisions they make.  To help patients understand diabetes treatment strategies they can download these guidelines by clicking here, and study them while considering their specific situation.   Adobe Acrobat is required to read the file.  Imagine the quality of visit a patient could experience if they used these guidelines to approach their physician with proposed improvements to their treatment plan?  The doctor may accept portions of the proposal, while recommending other improvements based on expertise and experience. 

What Can I Expect to Learn from the AACE Guideline?

Type 1 diabetics can start by jumping to page 16.  There it explains that the best thing a person can do for type 1 diabetes is initiate intensive diabetes therapy.  The guidelines walks readers through options for achieving it using either insulin injections or an insulin pump.  Each suggestion has a grade assigned to it.  Therapies labeled "grade A" are the most tried and true therapies, while a "grade D" therapy only has limited scientific support.  Keep in mind that there are some therapies that may recieve a C or D grade that may be outstanding therapies for select diabetics. 

People living with type 2 diabetes can jump to page 17 and read the recommendations there.  They can consider their current blood sugar readings and most recent A1cscore.  Patients not able to maintain an A1c score below 6.5 percent, or a fasting plasma glucose reading less than 110 mg/dL, can compare their current strategy with the steps in the guideline.  Keep in mind that your situation may be different from people with diabetes and your physician may be managing your diabetes with the appropriate strategy for your situation.  Regardless of the situation, by using these guidelines to create questions for an upcoming doctor's visit, a person will likely come away from that visit with new wisdom and a better strategy.  

For people new to diabetes, this information may be overwhelming. Those who have lived with it for a while and researched it will still find some new information.  Specifically, there is new information about the latest medication and insulin therapies.   These pages represent the most up-to-date diabetes information available.  In addition to the specific guidelines on managing type 1 and 2 diabetes above, the guidelines also include sections that explain:

• Diabetes prevention and prediabetes (p. 13)
• The many medication options and how they work. (p. 22)
• How to manage high blood pressure and the related medications. (p. 35)
• How to lower lipids or blood fat. (p. 40)
• The latest wisom on nutrition (p. 47)
• How to best manage diabetes in pregnancy (p. 55)

There are also sections on complications, patient safety, and diabetes care in the hospital.