Implementing treatment guidelines for type 2 diabetes in primary care.
The task of managing the ever-growing problem of type 2 diabetes falls mainly to primary care physicians. The currently available guidelines from the American Diabetes Association and the American College of Endocrinology/American Association of Clinical Endocrinologists aim to improve glycemic control, thus reducing morbidity and mortality associated with this chronic and progressive disease. However, the guidelines differ markedly in focus and depth. This review provides a clear summary of the guidelines and recommends how they can be implemented at the primary care level, explaining the different treatment options and providing practical advice on how commonly encountered situations should be approached in clinical practice. There is also a troubleshooting section on how to overcome obstacles to optimum therapy, and details on implementation strategies that will encourage the aggressive, stringent, and patient-centered, treat-to-target approach recommended in the guidelines.
Brunton
Stephen
S
University of North Carolina, Chapel Hill, NC, USA. ozdoc@aol.com