Comparison of Content and Quality of Caribbean, International, and High-Income Country-Specific Clinical Guidelines for Managing Type 2 Diabetes Mellitus

Purpose: Type 2 diabetes mellitus (T2DM) is poorly managed in the Caribbean; therefore, con-ducting an assessment of the content and quality of clinical guidelines will allow guideline de-velopers to detect and address the lacking information. Hence, this study aimed to benchmark and compare the clinical guideline for T2DM management from the Caribbean to a selection developed internationally and by high-income countries. Methods: Seven T2DM management clinical guidelines were selected a priori as a sample of international and high-income country-specific clinical guidelines and compared to the country-specific T2DM management clinical guideline from the Caribbean. Two reviewers independently assessed the content (using a previously pi-loted data extraction form) and quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results: The Caribbean clinical guideline was found to contain similar levels of T2DM management topics compared to international and high-income coun-try-specific clinical guidelines; however, one country-specific clinical guideline from New Zealand was found to have a substantially lower level of content. The clinical guideline from the Caribbean was found to have low-quality and could not be used in practice; however, only three comparator clinical guidelines were found to have a high-quality and could be recommended for use in clinical practice. A further three comparator clinical guidelines could be used in practice with minor modifications. Conclusion: Although the T2DM management clinical guideline from the Carib-bean contained a high level of content with regards to relevant topics, it was of insufficient quality to be used in clinical practice. Therefore, an alternative high-quality clinical guideline as identified within this study should be adopted and used within the Caribbean to manage T2DM until a high-quality region-specific clinical guideline is developed