Introduction

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Introduction

Diabetes is a major health issue that has reached a pandemic level. In Bangladesh, the treatment of diabetes is mainly provided by general physicians and specialist physicians, including endocrinologists and diabetologists, through government and private healthcare facilities. However, in some union-level government facilities, medical assistants detect high blood glucose and refer for treatment to physicians. Compliance with diabetes treatment is low mainly due to insufficient knowledge about disease control and prevention of complications, and the long-term cost of drugs in the case of poor patients. Lack of updated information and current recommendations on diabetes management for physicians are also important barriers to providing proper care. Although several international guidelines for diabetes management are now available, a guideline specific to the Bangladeshi population is required for the appropriate management of diabetes by physicians and healthcare providers working at various levels of the healthcare system in Bangladesh.

Objective

The objective of this national diabetes guideline is to provide clear and concise evidence to all healthcare providers on the current concepts in the management of diabetes. Since diabetes is managed by various levels of healthcare providers in Bangladesh, attempts are made to ensure that different stakeholders will benefit from this guideline.

Methods

To develop the guideline, the Noncommunicable Disease Control (NCDC) Program of the Directorate General of Health Services (DGHS) set up three groups – a working group, a task force group, and an advisory group. Both working and task force groups comprised leading experts from endocrinology, diabetology, internal medicine, nephrology, primary care medicine, and public health in Bangladesh. The advisory group consists of both renowned clinicians and government policymakers. Centre for Global Health Research, the Diabetic Association of Bangladesh (BADAS), and the Japan International Cooperation Agency (JICA) provided technical support. ‘Diabetes Care BADAS Guideline 2019’, a joint initiative of NCDC and BADAS, was a baseline document for guideline development. In addition, members of the working group reviewed recent diabetes care and prevention guidelines published by various internationally authoritative scientific and professional bodies. Also, they examined the recent reports on newer studies related to diabetes management to formulate a ‘zero draft.’ After completing the zero draft presentation, the working group members conducted a series of consultations. A draft document comprising seven chapters with a summary was developed. Each reference that was used to formulate this guideline was critically reviewed. The task force group, consisting of eighteen members, worked on this document and finalized it after making necessary changes. A four-member independent review committee reviewed this document, which was then uploaded to the DGHS website for public comments. Finally, the guideline was approved by the advisory group members.

Duration

June 2022 to November 2022