[Will drug therapy for diabetes be restricted by evidence-based guidelines or structured management programs (DMPs)?].
According to Sackett, a misunderstanding of what evidence-based medicine has given rise to the view that drug therapy must be based exclusively on the findings of RCTs (randomized Clinical Trials). In contrast, Sackett himself defines the practice of evidence-based medicine as integrating one's own clinical expertise, that is one's own daily clinical experience in the treatment of patients, with the best external clinical evidence from systematic research, not simply blindly acting upon the latter. It is in this sense that guidelines should be properly interpreted. Nor should it be overlooked that in disease management programs (DMPs) for the treatment of diabetes, although recommendations for the use of certain insulins or antidiabetic agents are made, the establishment of individual treatment aims is certainly of pre-eminent importance. Well-founded deviations from the recommendations made in DMPs are therefore admissible. Indications for the possible use of both short-acting and long-acting insulins are presented.
Bottermann
Von P
VP
peter.bottermann@lrz.tu-muenchen.de
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D019468:Disease Management; D004334:Drug Administration Schedule; D019317:Evidence-Based Medicine; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic
D015415:Biomarkers; D006442:Glycated Hemoglobin; D007328:Insulin