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Improving glucose management: Ten steps to get more patients with type 2 diabetes to glycaemic goal

Recommendations from the Global Partnership for Effective Diabetes Management

Authors

  • S. Del Prato,

    Corresponding author
    1. University of Pisa,1Pisa, Italy, Federation of European Nurses in Diabetes,2London, UK, Primary Care Diabetes Europe,3Surrey, UK, Lahey Clinic,4Burlington, MA, USA, International Diabetes Institute,5Caulfield, Australia, and Mount Sinai Hospital,6University of Toronto, Toronto, Canada
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  • 1 A-M Felton,

    1. University of Pisa,1Pisa, Italy, Federation of European Nurses in Diabetes,2London, UK, Primary Care Diabetes Europe,3Surrey, UK, Lahey Clinic,4Burlington, MA, USA, International Diabetes Institute,5Caulfield, Australia, and Mount Sinai Hospital,6University of Toronto, Toronto, Canada
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  • 2 N. Munro,

    1. University of Pisa,1Pisa, Italy, Federation of European Nurses in Diabetes,2London, UK, Primary Care Diabetes Europe,3Surrey, UK, Lahey Clinic,4Burlington, MA, USA, International Diabetes Institute,5Caulfield, Australia, and Mount Sinai Hospital,6University of Toronto, Toronto, Canada
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  • 3 R. Nesto,

    1. University of Pisa,1Pisa, Italy, Federation of European Nurses in Diabetes,2London, UK, Primary Care Diabetes Europe,3Surrey, UK, Lahey Clinic,4Burlington, MA, USA, International Diabetes Institute,5Caulfield, Australia, and Mount Sinai Hospital,6University of Toronto, Toronto, Canada
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  • 4 P. Zimmet,

    1. University of Pisa,1Pisa, Italy, Federation of European Nurses in Diabetes,2London, UK, Primary Care Diabetes Europe,3Surrey, UK, Lahey Clinic,4Burlington, MA, USA, International Diabetes Institute,5Caulfield, Australia, and Mount Sinai Hospital,6University of Toronto, Toronto, Canada
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  • and 5 B. Zinman 6

    1. University of Pisa,1Pisa, Italy, Federation of European Nurses in Diabetes,2London, UK, Primary Care Diabetes Europe,3Surrey, UK, Lahey Clinic,4Burlington, MA, USA, International Diabetes Institute,5Caulfield, Australia, and Mount Sinai Hospital,6University of Toronto, Toronto, Canada
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  • *

    Global Partnership for Effective Diabetes Management Members: George Alberti, University of Newcastle upon Tyne, Newcastle upon Tyne, UK; Pablo Aschner, Javeriana University School of Medicine, Bogota, Colombia; Cliff Bailey, Aston University, Birmingham, UK; Lawrence Blonde, Oschner Clinic Foundation, New Orleans, LA, USA; Stefano Del Prato, University of Pisa, Pisa, Italy (Chair); Anne-Marie Felton, Federation of European Nurses in Diabetes, London, UK; Barry Goldstein, Jefferson Medical College of Thomas Jefferson University, PA, USA; Ramon Gomis, Hospital Clinic, Barcelona, Spain; Edward Horton, Joslin Diabetes Center, Boston, MA, USA; James LaSalle, Medical Arts Research Collaborative, Excelsior Springs, MO, USA; Hong-Kyu Lee, Seoul National University, College of Medicine, Seoul, Korea; Lawrence Leiter, St Michael's Hospital, Toronto, ON, Canada; Stephan Matthaei, Diabetes-Zentrum Quakenbruck, Quakenbruck, Germany; Marg McGill, Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia; Neil Munro, Primary Care Diabetes Europe, Surrey, UK; Richard Nesto, Lahey Clinic, Burlington, MA, USA; Paul Zimmet, International Diabetes Institute, Caulfield, Australia; and Bernard Zinman, Mount Sinai Hospital, University of Toronto, Toronto, Canada.

Professor Stefano Del Prato, MD, Department of Endocrinology and Metabolism, Section of Diabetes-Ospedale Cisanello, Via Paradisa, 2, I-56124 Pisa, Italy
Tel.: + 39 (050) 995103
Fax: + 39 (050) 541521
Email: delprato@immr.med.unipi.it

Summary

Despite increasingly stringent clinical practice guidelines for glycaemic control, the implementation of recommendations has been disappointing, with over 60% of patients not reaching recommended glycaemic goals. As a result, current management of glycaemia falls significantly short of accepted treatment goals. The Global Partnership for Effective Diabetes Management has identified a number of major barriers that can prevent individuals from achieving their glycaemic targets. This article proposes 10 key practical recommendations to aid healthcare providers in overcoming these barriers and to enable a greater proportion of patients to achieve glycaemic goals. These include advice on targeting the underlying pathophysiology of type 2 diabetes, treating early and effectively with combination therapies, adopting a holistic, multidisciplinary approach and improving patient understanding of type 2 diabetes. Implementation of these recommendations should reduce the risk of diabetes-related complications, improve patient quality of life and impact more effectively on the increasing healthcare cost related to diabetes.

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