title: Evaluation and comparison of guidelines for the management of people with type 2 diabetes from eight European countries.
abstract: METHODS
  The most recent nationally recognised guidelines for type 2 diabetes from eight European countries (Belgium, England/Wales, France, Germany, Ireland, Italy, the Netherlands and Sweden) were compared. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was used for quality assessment. Details of recommendations for key process and outcome indicators were also extracted. Appraisal and data extraction were conducted independently by two researchers.
  
  
  RESULTS
  AGREE domain scores varied between guidelines, including a range of 31-95% for rigour of development. The highest mean domain scores were for Scope and Purpose (81%) and Clarity and Presentation (85%); the lowest was for Stakeholder Involvement (49%). Specific recommendations, including targets relating to intermediate outcomes, were broadly similar. However, at detailed level, there were variations, particularly in terms of the level of information provided, for example, only two countries' guidelines provided cut-off points in relation to risk associated with waist circumference.
  
  
  CONCLUSIONS
  Our findings suggest that there are some areas of good practice relating to guideline development where more attention is needed. Despite a substantial degree of consensus for specified targets, observed differences at detailed level suggest a lack of consistency in relation to some aspects of the information provided to clinicians across Europe.
authors.affiliation: University of Leicester, United Kingdom.
authors.forename: M A
authors.initials: MA
authors.lastname: Stone
authors.forename: J C
authors.initials: JC
authors.lastname: Wilkinson
authors.forename: G
authors.initials: G
authors.lastname: Charpentier
authors.forename: N
authors.initials: N
authors.lastname: Clochard
authors.forename: G
authors.initials: G
authors.lastname: Grassi
authors.forename: U
authors.initials: U
authors.lastname: Lindblad
authors.forename: U A
authors.initials: UA
authors.lastname: Müller
authors.forename: J
authors.initials: J
authors.lastname: Nolan
authors.forename: G E
authors.initials: GE
authors.lastname: Rutten
authors.forename: K
authors.initials: K
authors.lastname: Khunti
mesh_terms: D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000628:therapy*; D005060:Europe; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008019:Life Style; D020380:Needs Assessment / Q000592:standards; D017410:Practice Guidelines as Topic / Q000592:standards*; D011785:Quality Assurance, Health Care; D012648:Self Care; D015431:Weight Loss
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin