The ADA-EASD patient-centered guidelines for management of hyperglycemia: Are they patient-centered enough?

Abstract

Background: The American diabetes association (ADA) and European association for the study of diabetes (EASD) recently issued an updated position statement on the management of hyperglycemia in type 2 diabetes. The choice of nomenclature of these guidelines is refreshing as it highlights a patient-centered approach to managing diabetes.

Discussion: This debate looks at these guidelines through the prism of patient-centeredness, it tries to assess if the authors of the ADA-EASD position statement have been able to “walk the talk” with respect to the patient-centered approach that they advocate.

Conclusion: We conclude that the guidelines can be made more patient-centered, by emphasizing psychosocial and psychiatric comorbidity of diabetes, ethno pharmacy, and patient-friendly insulin regimes and oral fixed dose combinations, in a culturally competent, globally acceptable manner.

Keywords:

Basal insulin - cultural competence - diabetes - patient-centered care - premixed insulin - shared decision making

• References

• 1 Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M. et al. Management of hyperglycaemia in type 2 diabetes: A patient-centered approach.Position statement of the American diabetes association (ADA) and the European Association for the study of diabetes (EASD). Diabetologia 2012; 55: 1577-1596
• 2 Committee on Quality of Health Care in America. Crossing the quality chasm: Institute of medicine (U.S.) A new health system for the 21^st Century. Washington DC: The national academies press; 2001
• 3 Balhara YP. Diabetes and psychiatric disorders. Indian J Endocrinol Metab 2011; 15: 274-283
• 4 Kalra S, Ayyar V, Unnikrishnan AG. Adrenergic India: Managing its diabetes. Indian J Endocrinol Metab 2011; 15: 1-2
• 5 American Diabetes Association. Standards of medical care in diabetes – 2012. Diabetes Care 2012; 35: S11-S63
• 6 Ismail-Beigi F, Moghissi E, Tiktin M, Hirsch IB, Inzucchi SE, Genuth S. Individualizing glycemic targets in type 2 diabetes mellitus: Implications of recent clinical trials. Ann Intern Med 2011; 154: 554-559
• 7 Pan CY, Landen H. Post-marketing surveillance of acarbose treatment in patients with type 2 diabetes mellitus and subjects with impaired glucose tolerance in China. Clin Drug Investig 2007; 27: 397-405
• 8 Malone JK, Bai S, Campaigne BN, Reviriego J, Augendre-Ferrante B. Twice-daily pre-mixed insulin rather than basal insulin therapy alone results in better overall glycaemic control in patients with type 2 diabetes. Diabet Med 2005; 22: 374-381
• 9 Kalra S, Plata-Que T, Kumar D, Mumtaz M, Søndergaard F, Kozlovski P. et al. Initiation with once-daily BIAsp 30 results in superior outcome compared to insulin glargine in Asians with type 2 diabetes inadequately controlled by oral anti-diabetic drugs. Diabetes Res Clin Pract 2010; 88: 282-288
• 10 Kalra S, Kalra B, Sharma A, Chhabra B. Use of three dose premixed aspart: Clinical correlates. Endocr Abstr 2008; 16: 193
• 11 Venn BS, Williams SM, Mann JI. Comparison of postprandial glycaemia in Asians and Caucasians. Diabet Med 2010; 27: 1205-1208