‘Living guidelines’ coming for T1D and T2D

New Australian diabetes guidelines due to be released for public consultation mid-year are being developed as “living guidelines” that can be continuously updated as new evidence arises.

The Living Evidence for Diabetes Consortium, a partnership between the Australian Diabetes Society, Diabetes Australia, Australian Diabetes Educators Association, Australasian Paediatric Endocrine Group and Cochrane Australia, is currently working on two guidelines.

One is focussed on therapies for blood glucose control in adults with type 2 diabetes and another on the use of technologies for type 1 diabetes management in children and adults.

According to a Perspective article in the MJA, currently all but one of the NHMRC-approved diabetes clinical guidelines are outdated and have been rescinded.

“As a result, there is no up-to-date Australian guidance for clinicians caring for people with diabetes, potentially resulting in the suboptimal management and significant variation in care of this condition.”

Mr Heath White, Evidence Lead for the diabetes project and a senior research officer at Cochrane Australia, told the limbic that the approach to developing living guidelines will be as rigorous as for traditional static guidelines.

“It’s going to be very robust. There is the standard systematic review and work up as per usual,” he said.

However machine learning algorithms, an online collaborative platform and other advances were now supporting and speeding up the initial development process, while individual recommendations can be updated in a timely fashion as new evidence became available.

“Updated recommendations are then published within a real-time digital dissemination platform, providing stakeholders with access to the most up-to-date version of the guideline,” Mr White and colleagues wrote in the MJA.

“In addition, the establishment of a living guideline development group improves the retention of institutional memory throughout the process of updating, and the feedback mechanisms built into the process provide a means by which the underlying scope can be adapted to changes in policy and practice in Australia.”

Mr White said the main difference for clinicians would be accessing guidelines through the online MAGIC App platform where they could be quite sure the the document represented the current guidance.

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