Translating clinical guidelines into clinical practice: role of the pharmacist in type 2 diabetes management.
Objective: To examine the American Diabetes Association (ADA) and American College of Endocrinology (ACE)/American Association of Clinical Endocrinologists (AACE) diabetes guidelines and identify key areas for increased pharmacist involvement to allow more effective implementation of target glycemic goals.
Methods: Guidelines issued by ADA and ACE/AACE; PubMed searches were performed to identify additional data. Methods: Free text searches were performed to identify recent (2000-2008) therapy reviews in the management of type 2 diabetes, as well as articles on specific issues such as telemedicine, self-measurement of blood glucose, and overcoming barriers to treatment. To explore the role of insulin in managing type 2 diabetes, clinical trials involving insulins and insulin analogs in type 2 diabetes were identified using a PubMed search with the Mesh terms insulin or analogs and derivatives plus diabetes mellitus, type 2 and restricted to those published after 2000. The pharmacist's role in the treatment of type 2 diabetes was explored in PubMed using the Mesh terms pharmacists[Majr] and diabetes mellitus, type 2/therapy, and free text searches were also performed using the terms patient education, pharmacist, and type 2 diabetes. Methods: By the author.
Results: The increasing burden of type 2 diabetes highlights the need for tight glycemic control in line with current guidelines and the timely introduction of insulin. Pharmacists have a crucial role in achieving these goals, as they are ideally placed to educate patients about the acceptability of treatment, the importance of self-management, the availability of new technologies and delivery devices, and the need for treatment intensification to achieve glycosylated hemoglobin (A1C) targets.
Conclusions: Pharmacists play a crucial role in helping patients with type 2 diabetes achieve the A1C targets recommended by ADA and ACE/AACE and thereby improve their long-term health.