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IDF Releases New Guidelines for Worldwide Diabetes Treatment

At the 20th World Diabetes Congress in Montreal on October 25, 2009, the International Diabetes Federation (IDF) released 3 sets of diabetes guidelines for health care providers intended for improving patient care and halting the spread of the disease. The guidelines dealt with the self-monitoring of blood glucose, pregnancy, and oral health. The IDF Task Force on Clinical Guidelines’ mission is to meet the critical global need to provide up-to-date evidence-based information and training for health care professionals.

The IDF Global Guideline on Pregnancy and Diabetes (the first) aims to establish a global standard for the care of gestational diabetes and patients with diabetes who become pregnant. Gestational diabetes is common, and its frequency is increasing throughout the world.

The IDF also released guidelines on helping patients with diabetes manage their oral health, as well as perform regular self-monitoring of blood glucose. These guidelines are meant to improve often neglected areas of diabetes care.

Pregnant Women: Eat Your Veggies

A Swedish study recently found that the incidence of type 1 diabetes was lower in children born to mothers who ate plenty of vegetables during pregnancy. The results, published online in Pediatric Diabetes, found that 3% of 6000 5-yearolds either had fully developed type 1 diabetes or had elevated levels of antibodies that indicate a risk of developing the disease. Children whose mothers rarely ate vegetables during pregnancy had double the risk of developing type 1 diabetes, and the risk was lowest among children whose mothers ate vegetables every day of their pregnancy.

Study author Hilde Brekke, a clinical nutritionist at the Sahlgrenska Academy at the University of Gothenburg, and colleagues said that further studies are needed before anything definitive can be determined. “We cannot say with certainty on the basis of this study that it’s the vegetables themselves that have this protective effect.”

Lifestyle Changes, Metformin Lower Type 2 Risk

Researchers concluded, after analyzing 10 years of data, that intensive lifestyle changes (eg, weight loss) decreased the rate of developing type 2 diabetes in high-risk patients by 34%, compared with placebo. The results appear online in the Lancet (October 29, 2009) and include results from the Diabetes Prevention Program Outcomes Study (DPPOS), which looks at the interventions tested in the Diabetes Prevention Program (DPP).

Researchers found that, in the DPPOS—a continuation of the DPP, a large, randomized trial in 3234 overweight or obese adults with elevated glucose levels—the participant group (randomized to make lifestyle changes) had more favorable cardiovascular risk factors, like lower blood pressure and triglyceride levels, despite taking fewer drugs to control their heart disease risk. In addition, participants who received the oral diabetes drug metformin reduced the rate of developing diabetes by 18% after 10 years, compared with placebo.

Treatment for Even Mild Gestational Diabetes Helps Mothers and Babies

A study from the National Institutes of Health (NIH) showed conclusively that treatment of even the mildest form of gestational diabetes mellitus (GDM) in pregnant women can decrease the risk of common birth complications among infants and blood pressure disorders among mothers. The medical community has known that treatment of severe GDM benefits mothers and babies, but now evidence exists showing that treatment of the mild form also benefits both mother and baby.

Researchers from the National Institute of Child Health and Human Development enrolled 958 women with mild GDM. Approximately 50% were treated for their diabetes, and the other 50% were not and received only standard pregnancy care. Results of the study showed that the women treated for mild GDM had smaller, leaner babies less likely to be overweight, and less likely to experience shoulder dystocia. Those mothers who received treatment were also less likely to need a cesarean, to develop high blood pressure during pregnancy, or to develop preeclampsia, a complication that can cause seizures or death. The results were published in the October 1, 2009, issue of the New England Journal of Medicine. â– 

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FAST FACT: In the United States, 11% of adults (24 million individuals) have diabetes— up to 95% of them have type 2 diabetes.