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The Management of Type 2 Diabetes and the Metabolic Syndrome (2009)

The creation of evidence based and highly academic guidelines is very necessary, but in the ultimate analysis, they remain an academic exercise unless steps are taken to "translate" them into practical handbooks which would help those on the ground to offer patients good diabetes care.

In India, the day to day management of almost 99% of people is carried out by family practitioners and in many cases these are the only medical professionals that patients have access to. The picture of medical care is further compounded by the fact that many of these family physicians are not trained in the allopathic branch of medicine, but in many traditional branches such as ayurveda, unani, homeopathy, tribal medicine, and India even has a category called registered medical practitioners, akin to the barefoot doctors. In addition, many countries also do not have a system of compulsory continuing medical accredition, so even those who may have studies allopathy need to be in touch with the new developments.

Although evidence based and highly academic Guidelines are available, there is a general feeling and this is also the feedback which one gets in interactions with family and other physicians that they find these complicated and not what they want for the optimal day to day management of their patients. One may disagree with this, but these are ground realities. At the same time, they are keen to learn how to manage their patients better.

Even amongst the specialists, there seems to be a feeling that there is no effort to be inclusive and take their opinions and the realities under which they practice into account.

DiabetesIndia had initiated, and is in the process of updating the education and other materials to spread knowledge amongst the health givers as well as patients.

In order to make the education material more acceptable and so more usable by doctors all over India, DiabetesIndia has initiated a process wherein the academic Guidelines are modified into a more clinically oriented and practice focused mode. We would appreciate it if you could send in your inputs along with your contact details and acceptance of being a part of this initiative. 

We hope to have inputs from all over India in order to make this more inclusive, attuned to ground realities and more acceptable to the treating physicians all over this vast and heterogenous country who we feel are crucial to allow us to lower this burden of diabetes related foot disorders. 

The material will then be put in a format which can be used for education and also in a manner which the treating physician can easily use in the day to day practice.

The same material again modified for patients as well as the general public will be utilized for patient education in the form of lectures, patient booklets and handouts, newspaper articles, etc. Again, considering the heterogeneity of India, much of the patient material would be brought our tin different Indian languages as far as is possible. 

Once the inputs are in, the draft can then be modified and altered and again sent to the associations and key opinion leaders for further comments or acceptance.

This is an intermediate part and is such that we get feedback from the ground, and also allow the very important interactions which would allow us to help each other and thereby our patients with diabetes.

All involved should get equal credit and this would be truly joint initiative. This is in keeping with our thoughts that we must all work together as equals and it is only then that we would be able to do something for our people with diabetes. 

DiabetesIndia hopes that many of you will help out in this initiative.

We would appreciate your views, inputs and feedback on this initiative.

S.M. Sadikot

email: smsadikot@gmail.com