The principles included new and updated evidence over recent years in the field of diabetes self-management, education, and support, as well as shared decision-making skills and individualized care for patients.
Deepak L. Bhatt, MD, MPH
Last week, the National Diabetes Education Program (NEDP), under the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK) released an updated list of their Guiding Principles for the Care of People With or at Risk For Diabetes.
The principles, a ten-item list of generally agreed-to practices among prominent healthcare providers and agency guidelines, have included new and updated evidence over recent years in the field of diabetes self-management, education, and support, as well as shared decision-making skills and individualized care for patients. Supporting organizations of the principles include the American Diabetes Association, American Academy of Family Physicians, the Endocrine Society, National Institute on Minority Health and Health Disparities, and dozens more.
Deepak L. Bhatt, MD, MPH, of the American Heart Association, executive director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital Heart & Vascular Center and professor of medicine at Harvard Medical School, assisted in the writing, reviewing and research behind the updated principles. In an interview with MD Magazine®, Bhatt detailed the creation of the new guidelines, as well as the meaning behind all 10 principles.
MD Mag: What led to the creation of these new principles? What is the goal behind the update?
Bhatt: The idea was to produce something that is useful to people, both to healthcare providers and for people who are caring for others with diabetes and those at risk for it. That actually applies to a lot of people, and it was meant to be evidenced-based, focusing on all aspects of diabetes including the management—and hopefully, the prevention.
Our goal was to try to distill it down to 10 principles, because 10 is a nice number. There’s a lot of top-ten lists that are easier to remember, and they get attention from the media.
On the Guiding Principles:
There’s really a lot of ground covered there, and hopefully presented in a way that it’s useful for people on the front line practicing, or for patients and people at risk, or those who care for those with diabetes.
Is there anything you can imagine from these updated principles that may need to be updated again in the future?
One thing that’s rapidly changing right now, in terms of medications, there’s a lot of data coming out from different cardiovascular outcome trials from diabetes drugs, and their effect on cardiovascular outcomes including heart failure and even death. There’s going to be, every 6 months or so over the next few years, at least 1 mega-trial coming out with thousands of patients studied, randomized to some diabetes drug or placebo or an older drug. That’s really going to change the care of diabetic patients and really improve their outcomes tremendously.
Is there anything else you wanted to add?
I focused a lot on lifestyle, but there’s also discussion of medications in there, and even procedures like bariatric surgery and what its role might be in folks that are very overweight with out-of-control diabetes. It’s pretty comprehensive ranging, from lifestyle management through medical therapy, through even procedural care.