Quick Reading Diabetes Guidelines for Doctors and Patients [Guiding Principles]

The U.S. Department of Health and Human Services (HHS) has issued a new set of [Guidelines] for the diagnosis, treatment and management of diabetes patients and their high-risk groups. The [Guidelines] integrate the key points of diabetes and pre-diabetes guidelines organized by various medical societies, and aim to help clinicians [quickly read] the guidelines.

The document is funded by the federal government’s National Diabetes Education Program (NDEP) and jointly organized by the U.S. Centers for Disease Control and Preventive Health. The [Guiding Principles] have also been supported and recognized by several medical society organizations.

The document includes 10 chapters of management principles. At the end of each chapter, it briefly lists the main points and related articles for clinicians and patients to refer to (about 5 ~ 30 articles vs. hundreds of guidelines). In fact, it is equivalent to a [fast reading] index, helping people quickly link to the more detailed original guidelines.

Doctors don’t have much time to read the guide. The guidelines try to make the guide more concise and practical, increase its readability, and provide links to the entrance of relevant detailed guidelines.

10 Guiding Principles

1. Identify undiagnosed diabetes and pre-diabetes population.

2. Manage the pre-diabetic population to prevent and delay its progress to type 2 diabetes.

3. Provide continuous self-management education and support for patients with diabetes and diabetic complications and their high-risk groups.

4. Provide individualized nutrition treatment for diabetics and their high-risk groups.

5. Encourage diabetics and their high-risk groups to take regular physical exercise.

6. Control blood sugar, prevent or delay the occurrence and development of diabetic complications, and avoid hyperglycemia and hypoglycemia symptoms.

7. Actively control blood pressure and blood lipid, persuade smoking cessation, and take other measures to reduce the risk of cardiovascular diseases in patients.

8. Regularly monitor and evaluate diabetic microvascular complications and actively treat them to delay their progress.

9. The needs of special groups-children, women of childbearing age, the elderly and high-risk races and nationalities-need to be taken into account.

10. Provide patient-centered diabetes treatment.

Metformin Prevents Diabetes Mellitus

In Chapter 2, the document suggests that metformin can be considered to prevent diabetes, especially for those pre-diabetic people who have difficulty exercising and cannot lose 7% of their weight.

Although [metformin prevents diabetes] is supported by the Diabetes Prevention Program (DPP) and many other studies, this program has not been approved by the U.S. Food and Drug Administration (FDA). Moreover, due to the current widespread use of metformin, no company has tried to list it as one of the indications for prediabetes.

The control target is no longer [one size fits all]

In chapters 6 and 7, the document provides the goal of reaching a consensus on blood sugar and blood pressure control for diabetic patients, but at the same time it also emphasizes individualized treatment for patients.

The document no longer emphasizes the “one size fits all” control goal, but now focuses on how to prolong the life span of patients. For example, some patients need to quit smoking, while others need to change their lifestyle. For patients with short course of diabetes, blood sugar needs to be strictly controlled, while for patients with long course of diabetes, blood pressure and statins need to be controlled.