Emirates Diabetes Society Consensus Guidelines for the Management of Type 2 Diabetes Mellitus – 2020

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Abstract

Rapid urbanisation and socioeconomic development in the United Arab Emirates (UAE) have led to the widespread adoption of a sedentary lifestyle and Westernised diet in the local population and consequently a high prevalence of obesity and diabetes. In 2019, International Diabetes Federation statistics reported a diabetes prevalence rate of 16.3% for the adult population in the UAE. In view of the wealth of recent literature on diabetes care and new pharmacotherapeutics, the Emirates Diabetes Society convened a panel of experts to update existing local guidelines with international management recommendations. The goal is to improve the standard of care for people with diabetes through increased awareness of these management practices among healthcare providers licensed by national health authorities. These consensus guidelines address the screening, diagnosis and management of type 2 diabetes mellitus in adults including individuals at risk of developing the disease.

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Most cited references 59

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Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

Paul Nathan, Elizabeth Barrett, John M. Lachin … (2002)

Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

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2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020

(2019)

The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee (https://doi.org/10.2337/dc20-SPPC), a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

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Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance

Jaakko Tuomilehto, Jaana Lindström, Johan Eriksson … (2001)

New England Journal of Medicine, 344(18), 1343-1350

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Author and article information

Journal

Journal ID (publisher-id): DDE

Journal ID (doi): 10.1159/issn.2673-1738

Title: International Journal of Diabetes and Metabolism

Publisher: S. Karger AG

ISSN (Print): 2673-1797

ISSN (Electronic): 2673-1738

Publication date Subscription-year: 2020

Publication date (Print): December 2020

Publication date (Electronic): 19 February 2020

Volume: 26

Issue: 1

Pages: 1-20

Affiliations

[_a] _aEndocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates

[_b] _bDepartment of Medicine, Dubai Medical College, Dubai, United Arab Emirates

[_c] _cUniversity Hospital Sharjah, University of Sharjah, Sharjah, United Arab Emirates

[_d] _dEndocrinology Division, Tawam Hospital, Al Ain, United Arab Emirates

[_e] _eCollege of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates

[_f] _fMarina Health Promotion Center, Burjeel, United Arab Emirates

[_g] _gPublic Health Center, Department of Health Abu Dhabi, Abu Dhabi, United Arab Emirates

[_h] _hHealthcare Licensing and Medical Education, Department of Health Abu Dhabi, Abu Dhabi, United Arab Emirates

[_i] _iAlborj Medical Centre, Dubai, United Arab Emirates

[_j] _jMediclinic, Abu Dhabi, United Arab Emirates

[_k] _kNCD-Section, Ministry of Health and Prevention (MOHAP), Dubai, United Arab Emirates

[_l] _lDHIC, Dubai Health Authority, Dubai, United Arab Emirates

[_m] _mDubai Diabetes Center, Dubai Health Authority, Dubai, United Arab Emirates

[_n] _nRashid Hospital, Dubai, United Arab Emirates

[_o] _oPostgraduate Diabetes Education, Cardiff University, Cardiff, United Kingdom

[_p] _pDepartment of Endocrinology, Medcare Hospital, Dubai, United Arab Emirates

[_q] _qMohammed Bin Rashid University, Dubai, United Arab Emirates

[_r] _rAga Khan University, Karachi, Pakistan

[_s] _sMediclinic, City Hospital, Dubai, United Arab Emirates

[_t] _tHealthplus Diabetes and Endocrinology Center, Abu Dhabi, United Arab Emirates

[_u] _uCleveland Clinic, Abu Dhabi, United Arab Emirates

[_v] _vImperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates

[_w] _wImperial College, London University, London, United Kingdom

Author notes

*Fatheya Alawadi, Endocrine Department, Dubai Hospital, Dubai Health Authority, DHA, Alkhaleej Road, PO Box 7272, Dubai (UAE), ffalawadi@dha.gov.ae

Article

Publisher ID: 506508 Other ID: Dubai Diabetes Endocrinol J 2020;26:1–20

DOI: 10.1159/000506508

SO-VID: 4eb63df1-f6d9-4887-95f6-9c4aa70de8e2

License:

This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 12 February 2020

Date accepted : 14 February 2020

Page count

Figures: 6, Tables: 3, Pages: 20

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Karger: Endocrinology

Most cited references 59

Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020

Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance

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Cited by 8

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