ABSTRACT
Optimal management of individuals with type 2 diabetes involves complex decision-making to achieve and maintain control of blood glucose as well as other risk factors. The blueprint for care is generally considered the clinical practice guideline, which was developed to reduce inappropriate variations in practice and to promote the delivery of high-quality, evidence-based health care. The highest quality of evidence is generally considered to come from the randomised, controlled clinical trial. However, these are performed with the primary goal of understanding the efficacy of a therapy in a selected group of patients, which may perform differently in varying clinical settings and in broader patient populations than those studied in traditional randomised, controlled trials. The practice of evidence-based medicine should therefore integrate clinical information obtained from a patient with the best evidence available from clinical research and experience. The result is personalised management, a flexible, individual approach that considers important variables involved in a person’s diabetes care. Strategies tailored to the particular characteristics of individual patients have a number of advantages (Table 6.1) and promise to maximally improve the health of the population by optimising outcomes for each individual. This approach is highlighted in both the updated National Institute
for Health and Care Excellence (NICE) guidance (NICE, 2015) and the 2015 joint position statement from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (Inzucchi et al., 2015).
