Evidence for the missing links in existing cardiovascular diseases guidelines for low and middle income countries: the diabetes mellitus scenario from three continents
| Country/region | Malaysia/Asia | Brazil/South America | South Africa/Africa |
|---|---|---|---|
| Publication details | |||
| Year | 2015 | 2010 | 2012 |
| Title | Management of type 2 diabetes mellitus (5th edition)6 | Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society5 | The 2012 SEMDSA guideline for the management of type 2 diabetes (revised)7 |
| Authors | Ministry of Health, Malaysia | Lerario AC, et al | SEMDSA |
| Basis of recommendation | Modified from Scottish Intercollegiate guidelines network, systematic reviews, meta-analysis, local practice considerations | International literature, ADA/EASD algorithm. Joslin Diabetes Center | Update literature and the Department of Health's draft type 2 diabetes guideline document. |
| Specialties of the members of task force | Endocrinologists Family medicine specialists General physicians. Paediatric endocrinologists Public health physicians. Dieticians | NS | Endocrinologists Family Practitioners Diabetes Educators Department of Health representatives. Medical Council representatives |
| Methods in detail | Members of the task force were assigned topics. Articles retrieved were graded. Draft guideline was posted on the Malaysian Endocrine and Metabolic Society, Ministry of Health Malaysia websites for comment and feedback. Guideline presented to the Technical Advisory Committee and the Health Technology Assessment and Clinical Practice Guidelines Council, Ministry of Health for review and approval. | Brazilian Diabetes Society obtained opinions of a panel of renowned Brazilian specialist about recommendations and controversial arguments on the treatment of T2DM in international literature. Arguments were presented to the panel with each member scoring each argument on a Likert scale. | Broad topic of management was divided into smaller sections and allocated to experts to lead. Information on each section was presented to the general committee and amendments and additions suggested best on ‘best practice’. |
| Clinical issues addressed (components of the cardiovascular quadrangle) | |||
| Primordial prevention | No | No | Yes |
| Pre-diabetes | No | No | No |
| Age-specific treatment | No | No | Yes |
| Nutrition | Yes | No | Yes |
| Exercise | Yes | No | Yes |
| Acute care/emergencies | Yes | No | Yes |
| Conventional care | Yes | No | No |
| Rehabilitation | No | No | No |
| Target population (the 6Ps) | |||
| Physicians | Yes | NS | Yes |
| Nurses | Yes | NS | Yes |
| Primary caregivers | Yes | NS | Yes |
| Pharmacist | Yes | NS | No |
| Dieticians | Yes | NS | Yes |
| Policymakers | No | NS | Yes |
| Payers | No | NS | Yes |
| Paramedics | No | NS | No |
| Patients and populace | No | NS | No |
| Implementation partners | No | No | No |
| Other considerations (including translatability and ELSE) | |||
| Translatability rating | No | No | No |
| Ethical | No | No | No |
| Legal | No | No | No |
| Social | Yes | No | No |
| Psychological | Yes | No | No |
| Economic | No | No | No |
| Comorbidity | Yes | No | Yes |
| Quality indicator | Yes | Yes | No |
| Dissemination channels | No | No | No |
| Surveillance | No | No | No |
| Renewal date | 2019 | NS | NS |
ADA, American Diabetes Association; EASD, European Association for the Study of Diabetes; ELSE, ethical, legal, sociocultural and economic; NS, not stated; SEMDSA, Society for Endocrinology, Metabolism and Diabetes of South Africa; T2DM, type 2 diabetes mellitus.