IDF - working for people with diabetes around the world© IDF (Europe) 1998

A Desktop Guide to
Type 1 (Insulin-dependent) Diabetes

© 1998, International Diabetes Federation ( European Region ), Brussels

Introduction - Contents - Index - Authors - Acknowledgements - Copyright - IDF

Desktop Guide Type 2 Diabetes - click here

Contents and Sections
Index
Copyright and Reproduction
Introduction
Acknowledgements
Authors, Contacts, and Duality of Interest
File downloads (Word/HTML)
IDF


TYPE 1 DIABETES - COPYRIGHT and REPRODUCTION
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COPYRIGHT AND REPRODUCTION

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission of the copyright owner.

The International Diabetes Federation ( European Region ) ( IDF ( Europe ) ) nevertheless welcomes local reproduction of these Guidelines in whole or in part, by governmental, charitable, and other non-profit making bodies involved in the delivery of health-care. Approved non-English language versions of the Guidelines are being prepared, and must be used where available. Offers of assistance in translation into other languages are welcome. Any reproduction should be by written permission of IDF ( Europe ), and if modifications are made to suit local circumstances then this should be made explicit.

Commercial organizations in any sphere wishing to make use of these Guidelines are invited to contact IDF ( Europe ). IDF ( Europe ) has an agreement with the sponsors of this publication to allow reproduction in appropriate circumstances at a premium to the support level given by those sponsors. No permission will be given for any reproduction in association with product marketing.

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TYPE 1 DIABETES - COPYRIGHT and REPRODUCTION

TYPE 1 DIABETES - ACKNOWLEDGEMENTS
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ACKNOWLEDGEMENTS

The production of these Guidelines was made possible by the financial support of a consortium of industry partners of the St Vincent Declaration Initiative and IDF (Europe). The members of this consortium are :

Bayer Corporation, Diagnostics

Eli Lilly and Company

Glaxo Wellcome

Novo Nordisk

Roche Diagnostics

Zeneca Pharmaceuticals.

Additionally the European Diabetes Policy Group would like to thank Elizabeth Dempsey Becker of Novo Nordisk and Joachim Thiery of Roche Diagnostics for their organizational assistance and advice, and their companies for continuing their support of the original guidelines.

The Group is grateful to Hazel Glass for administrative support.

Style, content, and language editing of these Guidelines are by Elizabeth Home.

Web page design by Philip Home.

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TYPE 1 DIABETES - ACKNOWLEDGEMENTS

TYPE 1 DIABETES - CONTENTS
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CONTENTS

How Do I :

Ensure effective delivery of care - Sections 1-4

1. Organize a person's diabetes care
2. Conduct a diabetes consultation
3. Monitor diabetes care
4. Monitor my performance

Promote effective self-care - Sections 5-8

5. Empower a person with diabetes
6. Provide skills, motivation and understanding
7. Provide self-monitoring and self-management skills
8. Advise on life-style ( travel / licences / insurance / jobs )

Control blood glucose, blood lipids, arterial risk factors - Sections 9-14

9. Define and use blood glucose targets
10. Provide eating and drinking advice
11. Advise on physical exercise
12. Use insulin effectively ( initiate / adjust / analogues )
13. Cope with hypoglycaemia problems
14. Detect and manage arterial risk factors / lipids

Detect and manage diabetes complications - Sections 15-18

15. Kidney damage and high blood pressure
16. Eye damage
17. Foot problems
18. Nerve damage

Manage special problems - Sections 19-21

19. Pregnancy in women with diabetes
20. Surgery in people with diabetes
21. Ketoacidosis
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TYPE 1 DIABETES - CONTENTS

TYPE 1 DIABETES - PREFACE
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PREFACE

A desktop guide

In 1993 the European IDDM Policy Group published the Consensus Guidelines for Management of Insulin-dependent ( Type 1 ) Diabetes on behalf of the St Vincent Declaration Initiative.

The current initiative builds on those earlier guidelines, in the light of newer understandings, and attempts to provide a more direct and more accessible format.

Furthermore, we have tried to use language that can be followed by the educated person with diabetes, remembering that "the primary resource for diabetes care is the person with diabetes themselves, supported by enthusiastic and well-trained professionals".

The special requirements of children are not addressed here.

Evidence

The 1993 Consensus Guidelines were explicit about the knowledge base used. In an attempt to raise clarity, the current Desktop Guide is more prescriptive. However, we will also be publishing a source document in a major journal; this will go even further than the previous Guidelines in documenting the strength of the recommendations given here.

Aims of diabetes care

The aim to which these guidelines aspire is to enable a life of normal length and fulfilment for people with diabetes through:

A way forward

The 1998 European Diabetes Policy Group worked on both the major types of diabetes - there is a sister publication on Type 2 diabetes. The working group came from richer and poorer nations throughout Europe, and included people with diabetes, as well as members of multi-disciplinary teams.

We hope you will enjoy implementing these shared ideas. The practice of diabetes care is not always easy, but the human interest and gain to health are potentially large.

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TYPE 1 DIABETES - PREFACE

TYPE 1 DIABETES - EUROPEAN DIABETES POLICY GROUP
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EUROPEAN DIABETES POLICY GROUP

Contacts

Correspondence to : Professor Philip Home, Department of Medicine, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK. E-mail : philip.home@newcastle.ac.uk

International Diabetes Federation (European Region), 1 rue Defacqz, B 1000 Brussels, Belgium. Tel : +32 2537 1889; Fax : +32 2537 1981; E-mail : idfeuro@ping.be

Further information about IDF ( worldwide - the parent organization ) can be found at www.idf.org

Participating members

M Aguilar
K G M M Alberti ( joint chairman )
S A Amiel
J Azzopardi
C Berne
R W Bilous
K Borch-Johnsen
G Cathelineau
P V M Cromme
A Dawson
R Elphick
A Ericsson
D R Hadden
R J Heine
P D Home ( joint chairman )
I Kalo
T Kangas
R Landgraf
T Lauritzen
M Massi-Benedetti
A Mitrakou-Fanariotou
T Pieber
A Pruijs-Brands
H Schatz
W Scherbaum
A Serhiyenko
J Sieradzki
P Swift
L Uccioli
P Van Crombrugge
W H J M Wientjens
M T Yilmaz
H Yki-Järvinen
Cadiz, Spain
Newcastle upon Tyne, UK
London, UK
Gwardamangia, Malta
Uppsala, Sweden
Middlesbrough, UK
Gentofte, Denmark
Paris, France
Twello, The Netherlands
London, UK
Brussels, Belgium
Loderup, Sweden
Belfast, Northern Ireland
Amsterdam, The Netherlands
Newcastle upon Tyne, UK
Copenhagen, Denmark
Vantaa, Finland
Munich, Germany
Aarhus, Denmark
Perugia, Italy
Athens, Greece
Graz, Austria
Zeist, The Netherlands
Bochum, Germany
Düsseldorf, Germany
Lviv, Ukraine
Krakow, Poland
Leicester, UK
Rome, Italy
Aalst, Belgium
Waddinxveen, The Netherlands
Istanbul, Turkey
Helsinki, Finland

Statement of duality of interest

A number of members of the Policy Group, personally or through their employers, hold research contracts with, or provide consultation to, governmental and commercial organizations ( including the sponsors ) with an interest in areas covered by these Guidelines.

While travel and subsistence costs of the Policy Group's consensus meeting were covered by a grant to the University of Newcastle upon Tyne by the sponsors, no member of the Group has received any fee in connection with this activity. A fee commensurate with the editorial work performed was however received by the spouse of one of the Chairmen.

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TYPE 1 DIABETES - EUROPEAN DIABETES POLICY GROUP

TYPE 1 DIABETES - INDEX
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INDEX TO TYPE 1 DIABETES GUIDELINES

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Albumin excretion rate
Amputation
Annual Review assessments
Annual Review tasks
Arterial risk factors
Autonomic neuropathy
Blood fats
Blood glucose control targets
Blood glucose monitoring
Blood pressure assessment levels
Blood pressure ( hypertension )
Blood pressure if raised AER
Care delivery ( consultation )
Care delivery ( organization )
Care team
Children ( special requirements not addressed )
Consultation
Contraception
Diabetic ketoacidosis
Diarrhoea
Diet
Doctor/team consultation
Driving licences
Education of patients
Employment
Empowerment of patients
Exercise
Eye damage (retinopathy)
Foot problems
Gastroparesis
GIK
Glucagon
Glycated haemoglobin
Gustatory sweating
Heart disease
Hypertension
Hypertension - assessment levels
Hypertension ( if raised AER )
Hypoglycaemia
Hypoglycaemia - nocturnal
Hypoglycaemia unawareness
Impotence
Indicators of quality
Insulin therapy
Insurance
Ischaemic heart disease
Ketoacidosis
Ketones
Kidney damage (nephropathy)
Lipid assessment levels
Lipids - management
Living with diabetes
Microalbuminuria
Monitoring - arterial risk targets
Monitoring - glucose targets
Monitoring - quality
Monitoring - self
Nephropathy
Nerve damage ( foot care )
Nerve damage ( neuropathy )
Neuropathy
Neuropathy ( foot )
Nocturnal hypoglycaemia
Nutritional management
Painful neuropathy
Patient empowerment
Pregnancy
Pre-pregnancy counselling
Quality development
Quality indicators
Quality monitoring
Retinopathy
Self-management ( education for )
Self-management ( empowerment )
Self-management ( self-testing )
Self-monitoring
Smoking
Stress
Surgical management
Targets for glucose control
Targets for lipid and blood pressure control
Teams
Travel
Weight and eating

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TYPE 1 DIABETES - INDEX