Heinz Krombholz
Motor development of first born compared to later born children in the first two years of life - A replication
Heliyon
extensive evidence optimal management diabetes offering opportunity improving immediate longterm quality life diabetesunfortunately optimal management reaching many perhaps majority people could benefi treasons include size complexity evidencebase complexity diabetes care itselfone result lack proven costeffective resources diabetes careanother result diversity standards clinical practiceguidelines one part process seeks address problemsmany guidelines appeared internationally nationally locally recent years used rigorous new guideline methodologies identifi cation analysis evidencemany countries around world resources either expertise fi nancially needed develop diabetes guidelinesalso repetitive approach would enormously ineffi cient costlypublished national guidelines come relatively resourcerich countries may limited practical use less well resourced countriesin 2005 fi rst idf global guideline type 2 diabetes developedthis presented unique challenge tried develop guideline sensitive resource costeffectiveness issuesmany national guidelines address one group people diabetes context one healthcare system one level national healthcare resourcesthis true global context although every healthcare system seems short resources funding expertise available healthcare vary widely countries even localitiesdespite challenges feel found approach least partially successful addressing issue termed levels care see next pagethis guideline represents update fi rst guideline extends evidence base including new studies treatments emerged since original guideline produced 2005funding essential activity kindidf grateful diversity commercial partners provision unrestricted educational grants levels careall people diabetes access broad range diabetes services therapies person denied element effective diabetes careit recognised many parts developing world implementation particular standards care limited lack resourcesthis guideline provides practical approach promote implementation costeffective evidencebased care settings resources vary widelythe approach adopted advise three levels care recommended care evidencebased care costeffective nations well developed service base healthcare funding systems consuming signifi cant part national wealthrecommended care available people diabetes aim healthcare system achieve level carehowever recognition considerable variations resources throughout world levels care described acknowledge low high resource situationslimited care lowest level care anyone diabetes receiveit acknowledges standard medical resources fullytrained health professionals often unavailable poorly funded healthcare systemsnevertheless level care aims achieve limited costeffective resources high proportion achieved recommended careonly low cost high costeffectiveness interventions included level cd4agree care plan person diabetes review annually often appropriate modify according changes wishes circumstances medical fi ndings cd5use protocoldriven diabetes care deliver care plan scheduled routine visits annual reviews cd6provide urgent access diabetes healthcare advice unforeseen problems cd7organise care around person diabetes cd8use multidisciplinary care team specifi c diabetes expertise maintained continuing professional education cd9ensure person diabetes recorded list people diabetes facilitate recall annual complications surveillance cd10provide telephone contact clinic visits cd11consider people diabetes acting expert patients knowing limitations together localregionalnational associations might involved supporting care delivery local healthcare team cd12use data gathered routine care support quality assurance development activities care delivery recommendationsrecommended care cd1offer care people diabetes sensitivity cultural wishes desires