Content and quality of clinical practice guidelines for the management of type 2 diabetes in India: A systematic review

Olujide, Oluwasegun P; Olujide, Mariama E; Leonardi‐Bee, Jo; Chattopadhyay, Kaushik

doi:10.1002/edm2.405

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…Both FBG and PPBG levels need to be controlled for better outcomes. The RSSDI consensus suggests the initiation of the IDeg-Asp co-formulation as an alternative to basal insulin for better management of the glycemic control in T2D [17,18]. The IDegAsp co-formulation insulin analog is a promising insulin therapy, non-inferior to premixed insulin formulations, and a potential alternative to basalonly and basal-bolus insulin therapies for T2D management [19].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Insulin Degludec/Insulin Aspart (IDegAsp) vs. Insulin Glargine (IGlarU300) in Insulin-Naïve Patients with Type 2 Diabetes: A Retrospective Study

Hasnani,

Jha,

Saboo

et al. 2024

Clin Diabetol

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Objective: To investigate the efficacy of insulin degludec/insulin aspart (IDegAsp) co-formulation versus insulin glargine U300 (IGlarU300) in insulin-naïve individuals with type 2 diabetes (T2D) who had inadequate glycemic control with three oral antidiabetic drugs. Materials and methods: In this multicenter, retrospective, observational study, insulin-naïve individuals with T2D were subjected to standard care. Healthcare practitioners across this multicentric study initiated treatment with either IDegAsp (group 1) or IGlarU300 (group 2) as the insulin of choice. The participants' glycometabolic parameters, such as weight, body mass index (BMI), creatinine, hemoglobin A1c (HbA1c), fasting blood glucose (FBG), and postprandial blood glucose (PPBG) levels were analysed over 6 months. Changes in these parameters over 6 months were evaluated. Statistical significance was determined using the t-test. Results: Both treatment groups showed equivalent improvements in glycometabolic parameters, such as HbA1c, creatinine, FBG, PPBG levels, and hypoglycemic episodes over 6 months when compared to the baseline levels. Additionally, at every follow-up, the weight and BMI of both groups were similar. No severe hypoglycemic events were observed in either treatment group. Conclusions: Our findings support that IDegAsp is non-inferior to IGlarU300 and may be considered for treatment in insulin-naïve people with inadequately controlled T2D as an initiation insulin option.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Insulin Degludec/Insulin Aspart (IDegAsp) vs. Insulin Glargine (IGlarU300) in Insulin-Naïve Patients with Type 2 Diabetes: A Retrospective Study

Hasnani,

Jha,

Saboo

et al. 2024

Clin Diabetol

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“…However, no such T2DM clinical guideline is available in Nepal for Ayurvedic practitioners, but such clinical guidelines are available in India ( 8 , 9 , 23 – 25 ). However, their quality is questionable due to several factors, including whether the best available scientific evidence was taken into consideration ( 26 ). Most of these clinical guidelines are short and limited in scope and have heterogeneous content with no clear recommendations for action at the different stages of the care pathway ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

“…However, their quality is questionable due to several factors, including whether the best available scientific evidence was taken into consideration ( 26 ). Most of these clinical guidelines are short and limited in scope and have heterogeneous content with no clear recommendations for action at the different stages of the care pathway ( 26 ). Based on the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, which covers domains like scope and purpose of the guideline, stakeholder involvement, the rigor of development, clarity of presentation, applicability, and editorial independence ( 27 ), the overall quality of these clinical guidelines is poor, and these guidelines cannot be recommended for use in clinical practice ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

“…Most of these clinical guidelines are short and limited in scope and have heterogeneous content with no clear recommendations for action at the different stages of the care pathway ( 26 ). Based on the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, which covers domains like scope and purpose of the guideline, stakeholder involvement, the rigor of development, clarity of presentation, applicability, and editorial independence ( 27 ), the overall quality of these clinical guidelines is poor, and these guidelines cannot be recommended for use in clinical practice ( 26 ). Poor quality clinical guidelines can lead to ineffective interventions’ usage and limited resources’ inefficient usage and can harm patients ( 28 ).…”

Section: Introductionmentioning

confidence: 99%

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Development process of a clinical guideline to manage type 2 diabetes in adults by Ayurvedic practitioners

et al. 2023

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BackgroundType 2 diabetes mellitus (T2DM), a common chronic health condition, has major health and socioeconomic consequences. In the Indian subcontinent, it is a health condition for which individuals commonly consult Ayurvedic (traditional medical system) practitioners and use their medicines. However, to date, a good quality T2DM clinical guideline for Ayurvedic practitioners, grounded on the best available scientific evidence, is not available. Therefore, the study aimed to systematically develop a clinical guideline for Ayurvedic practitioners to manage T2DM in adults.MethodsThe development work was guided by the UK’s National Institute for Health and Care Excellence (NICE) manual for developing guidelines, the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. First, a comprehensive systematic review was conducted which evaluated Ayurvedic medicines’ effectiveness and safety in managing T2DM. In addition, the GRADE approach was used for assessing the certainty of the findings. Next, using the GRADE approach, the Evidence-to-Decision framework was developed, and we focused on glycemic control and adverse events. Subsequently, based on the Evidence-to-Decision framework, a Guideline Development Group of 17 international members made recommendations on Ayurvedic medicines’ effectiveness and safety in T2DM. These recommendations formed the basis of the clinical guideline, and additional generic content and recommendations were adapted from the T2DM Clinical Knowledge Summaries of the Clarity Informatics (UK). The feedback given by the Guideline Development Group on the draft version was used to amend and finalize the clinical guideline.ResultsA clinical guideline for managing T2DM in adults by Ayurvedic practitioners was developed, which focuses on how practitioners can provide appropriate care, education, and support for people with T2DM (and their carers and family). The clinical guideline provides information on T2DM, such as its definition, risk factors, prevalence, prognosis, and complications; how it should be diagnosed and managed through lifestyle changes like diet and physical activity and Ayurvedic medicines; how the acute and chronic complications of T2DM should be detected and managed (including referral to specialists); and advice on topics like driving, work, and fasting including during religious/socio-cultural festivals.ConclusionWe systematically developed a clinical guideline for Ayurvedic practitioners to manage T2DM in adults.

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