New guidelines for the management of diabetes: a physician’s guide

The 1998 Clinical Practice Guidelines for the Management of Diabetes inCanada (distributed as a supplement to this issue of CMAJ) incorpo-rate recent advances in diagnosis and outpatient management of dia-betes mellitus and explicitly identify and assess the evidence in support of the recommendations. These guidelines are not intended as a textbook of diabetes care; rather, they address key issues and areas of controversy. We hope that they will also form the basis for care maps and locally adapted guidelines across Canada. Technical review articles for each area of the document are now being developed with the primary care physician in mind. Canada and the world are experiencing a burgeoning epidemic of diabetes. The prevalence rate is expected to reach 3 million by the year 2010 in Canada alone. Professionals at all levels of the health care system can expect to see more patients with this multifaceted disease and to encounter more challenges in their treatment. The new guidelines recommend screening everyone over 45 years of age, using easier and more sensitive diagnostic procedures, managing diabetes with a view to attaining tighter control of glucose levels, and screening people with diabetes for long-term complications with more defined methods to improve the chances o