@article{2987865,
    title = "Gaps in guidelines for the management of diabetes in low- and middle-income versus high-income countriesda systematic review",
    author = "Owolabi, M.O. and Yaria, J.O. and Daivadanam, M. and Makanjuola, A.I. and Parker, G. and Oldenburg, B. and Vedanthan, R. and Norris, S. and Oguntoye, A.R. and Osundina, M.A. and Herasme, O. and Lakoh, S. and Ogunjimi, L.O. and Abraham, S.E. and Olowoyo, P. and Jenkins, C. and Feng, W. and Bayona, H. and Mohan, S. and Joshi, R. and Webster, R. and Kengne, A.P. and Trofor, A. and Lotrean, L.M. and Praveen, D. and Zafra-Tanaka, J.H. and Lazo-Porras, M. and Bobrow, K. and Riddell, M.A. and Makrilakis, K. and Manios, Y. and Ovbiagele, B.",
    journal = "DIABETES CARE",
    year = "2018",
    volume = "41",
    number = "5",
    pages = "1097-1105",
    publisher = "American Diabetes Association Inc.",
    issn = "0149-5992",
    doi = "10.2337/dc17-1795",
    keywords = "clinical outcome;  clinical practice;  comparative study;  evidence based medicine;  health care personnel;  health care policy;  high income country;  human;  legal aspect;  low income country;  medical ethics;  middle income country;  non insulin dependent diabetes mellitus;  patient care;  practice guideline;  Review;  socioeconomics;  systematic review;  treatment planning;  developed country;  developing country;  diabetes mellitus;  economics;  income;  poverty;  practice guideline;  protocol compliance;  standards;  statistics and numerical data, Developed Countries;  Developing Countries;  Diabetes Mellitus;  Guideline Adherence;  Health Personnel;  Humans;  Income;  Poverty;  Practice Guidelines as Topic",
    abstract = "OBJECTIVE: The extentto which diabetes (DM) practice guidelines, often basedon evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND METHODS: Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences. RESULTS: Most LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination planaswellassocioeconomic and ethical-legal contextualization.LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines (P < 0.001). CONCLUSIONS: A new approachto the contextualization, content development, and deliveryofLMIC guidelines is needed to improve outcomes. © 2018 by the American Diabetes Association."
}