New SIGN Guidelines31 Mar 2010

How to use the SIGN Guideline 116 "Management of Diabetes"

Introduction

These are by far the easiest and most helpful of Guidelines. These notes will explain how to navigate your way through them to find the information you want. There are three documents:

i] Full guideline

ii] Quick reference guide

iii] A booklet for patients and carers

All these are available as .pdf files which you can download and/or print out. Just go to the SIGN website www.sign.ac.uk.

How to use the guidelines

There are three new sections in the guideline compared with the previous guideline (SIGN 55). All the other section have received major updates except for the section on feet which has only received minor updating. Hence:

Section 2 Key recommendations (New)

Section 3 Lifestyle management (Updated)

Section4 Psychological factors (Updated)

Section 5 Management of Type 1 diabetes (Updated)

Section 6 Pharmacological managemtn of glycæmic control in people with type 2 diabetes (New)

Section 7 Management of diabetes in pregnancy (Updated)

Section 8 Management of diabetic cardiovascular disease (Updated)

Section 9 Management of kidnet disease in diabetes (Updated)

Section 10 Prevention of visual impairment (Updated)

Section 11 Management of diabetic foot disease (Minor updates)

Section 12 Provision of information (New)

The new Section 6 on drugs is excellent and the chart for this section in the Quick Reference Guide is first class and much, much easier to follow than that produced by NICE.

You might want to do one of the following:

1. Respond to requests for information from a patient
Print out the Booklet for Patients and Carers

2. Look for general guidance on, for example, the things you should be doing in your Diabetes Clinic
Check the Quick Reference Guide

3. Look for detailed guidance on specific questions of diabetes management
Check the Full Guideline as follows:

Full Guideline

This is a long document although it is written in a style which is easy to read and follow. Even individual sections are long and it may be difficult to find what you are looking for.

However, the people at SIGN have thought of two things to help you find what you are looking for. These are:

i] Section 2
This lists all the Key Recommendations and Good Practice Points section by section with the "Grade of Recommendation" for each recommendation from A to D.

ii] Annex 1
This sounds dry but is absolutely brilliant. It is towards the end of the guidelines (page 130) and lists all the Key questions which SIGN addressed in the producing of the guidelines. For example "Does race affect the efficacy of antihypertensive therapy in people with diabetes and CKD ?" The second column gives the sub-section where the answer to this question may be found.