Translating clinical guidelines into clinical practice: role of the pharmacist in type 2 diabetes management.
OBJECTIVE
To examine the American Diabetes Association (ADA) and American College of Endocrinology (ACE)/American Association of Clinical Endocrinologists (AACE) diabetes guidelines and identify key areas for increased pharmacist involvement to allow more effective implementation of target glycemic goals.


METHODS
Guidelines issued by ADA and ACE/AACE; PubMed searches were performed to identify additional data.


METHODS
Free text searches were performed to identify recent (2000-2008) therapy reviews in the management of type 2 diabetes, as well as articles on specific issues such as telemedicine, self-measurement of blood glucose, and overcoming barriers to treatment. To explore the role of insulin in managing type 2 diabetes, clinical trials involving insulins and insulin analogs in type 2 diabetes were identified using a PubMed search with the Mesh terms insulin or analogs and derivatives plus diabetes mellitus, type 2 and restricted to those published after 2000. The pharmacist's role in the treatment of type 2 diabetes was explored in PubMed using the Mesh terms pharmacists[Majr] and diabetes mellitus, type 2/therapy, and free text searches were also performed using the terms patient education, pharmacist, and type 2 diabetes.


METHODS
By the author.


RESULTS
The increasing burden of type 2 diabetes highlights the need for tight glycemic control in line with current guidelines and the timely introduction of insulin. Pharmacists have a crucial role in achieving these goals, as they are ideally placed to educate patients about the acceptability of treatment, the importance of self-management, the availability of new technologies and delivery devices, and the need for treatment intensification to achieve glycosylated hemoglobin (A1C) targets.


CONCLUSIONS
Pharmacists play a crucial role in helping patients with type 2 diabetes achieve the A1C targets recommended by ADA and ACE/AACE and thereby improve their long-term health.
Drab
Scott
S
University Diabetes Care Associates, School of Pharmacy, University of Pittsburgh, PA 15261, USA. drab@pitt.edu
D000465:Algorithms; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004513:Education, Pharmacy, Continuing; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D010353:Patient Education as Topic; D010595:Pharmacists; D017410:Practice Guidelines as Topic; D024382:Professional Role; D015430:Weight Gain
D007328:Insulin