Diabetes - Medical Practice Guidelines
Introduction
Diabetes is a chronic illness requiring continual medical care
and education in order to prevent acute complications and reduce the risk of
long-term medical problems. In Florida, over 1,000,000 individuals have been
diagnosed as having diabetes. It is estimated that over 300,000 additional adults
have diabetes but will not know it until confronted with one of its serious
complications.
Recognizing the devastating effects of this disease without a comprehensive
approach to treatment, the Florida Legislature passed legislation in 1996 that
requires all insurance policies and HMO plans to provide coverage for all medically
appropriate equipment and supplies in addition to diabetes outpatient
self-management training and educational services used to treat diabetes. The
legislation directed the Florida Agency for Health Care Administration to develop
standards for self-management training.
In 1997 the agency, in conjunction with the Department of Health, Florida affiliate
of the American Diabetes Association, endocrinologists, internists, dietitians,
diabetes self-management educators and other experts in the delivery of treatment
services for individuals with diabetes, developed the initial practice guidelines
to address the complex needs of patients with this illness.
In 2001 revisions were made to the original guidelines to reflect the most current
medical standards used in the treatment of children and adults having Type 1
and Type 2 diabetes. It is important for members of the health care team to
consider the following:
- Each patient is an individual and requires care that addresses their individual specific medical and psycho-social needs. It is imperative that the intensity and level of medical and psycho-social support necessary to accomplish treatment goals meet ongoing changes in the patient’s needs, care and lifestyle.
- A critical element for the successful treatment of all patients with diabetes is participation in a comprehensive self-management care and education program. Ongoing support, maintenance, and modifications in treatment regimes and lifestyle changes, all require continued patient and caregiver participation. Self-management education is necessary to accomplish these goals.
The guidelines are organized into the following areas: Definitions, Minimum Standards of Care for Children and Adults (which includes guidelines for hospital admission, initial and follow-up assessments), Strategies for Treatment of Gestational Diabetes, Guidelines for a Comprehensive Diabetes Self-Management Treatment Program, References, and Appendices.
