VA/DOD Clinical Practice Guideline for Management of Yype 2 Diabetes Mellitus in Primary Care Guideline Summary

The guideline describes the critical decision points in the Management of Diabetes Mellitus (DM) and provides clear and comprehensive evidence based recommendations incorporating current information and practices for practitioners throughout the DoD and VA Health Care systems. The guideline is intended to improve patient outcomes and local management of patients with diabetes mellitus.

(This Clinical Practice Guideline is intended for use only as a tool to assist a clinician/healthcare professional and should not be used to replace clinical judgment.)

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Physician References & Medical Handbooks can be found here: https://bookstore.gpo.gov/catalog/physician-references-medical-handbooks

Diabetes & Obesity publications can be found here: https://bookstore.gpo.gov/catalog/diabetes-obesity

Other products produced by the U.S. Department of Veterans Affairs (VA) are available here: https://bookstore.gpo.gov/agency/department-veterans-affairs-va

Table of Contents for Clinician Summary:

I. Introduction .................................................................................................................................. 3

II. Background................................................................................................................................... 3

A. Description of Diabetes Mellitus...................................................................................................... 3

B. Epidemiology and Impact................................................................................................................. 5

III. Scope of this CPG........................................................................................................................... 6

IV. Shared Decision-making and Patient-centered Care ...................................................................... 6

V. Guideline Work Group................................................................................................................... 8

VI. Algorithm...................................................................................................................................... 9

A. Module A: General Care and Treatment........................................................................................10

B. Module B: Diabetes Self-Management Education ........................................................................11

VII. Recommendations ...................................................................................................................... 12

VIII. Glycemic Control Targets and Monitoring.................................................................................... 14

IX. Pharmacological Therapy ............................................................................................................ 15

X. Methods...................................................................................................................................... 29

A. Strength of Recommendations ......................................................................................................29

B. Recommendation Categorization...................................................................................................31

References ............................................................................................................................................ 33

Target audience are medical professionals with a specialization in diabetes care.  This Clinical Practice Guideline is based on a systematic review of both clinical and epidemiological evidence. Developed by a panel of multidisciplinary experts, it provides a clear explanation of the logical relationships between various care options and health outcomes while rating both the quality of the evidence and the strength of the recommendations.

Variations in practice will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation.