Treatment guidelines are freely available. However, there are limited data on clinical outcomes comparing different treatment schedules. Here is how the evidence based medicine evolved as far as diabetes is concerned.

        Team@CMHF

Diabetes has reached epidemic proportions throughout the world. There is overwhelming evidence that the diabetes burden can be reduced through prevention and improving overall diabetes management. Despite the available evidence, strategies have not been widely incorporated into clinical practice, and the care received by many people with diabetes is less than optimal worldwide.

Evidence-based diabetes guidelines are an essential tool for redressing this situation. The evidence-based guideline movement has evolved over many years in response to the explosion of medical knowledge, a perceived need to protect against the potential for biases in the consensus approach, and the ever-increasing need to optimize the cost-effectiveness of treatment interventions. Evidence-based medicine is designed to complement and integrate clinical experience.

The International Diabetes Federation is leading a worldwide movement to make diabetes care more consistent, more systematic, and more accountable through engagement of the international diabetes community in the development and implementation of guidelines. There has been much progress over the past 25 years. Evidence based medicine is now firmly entrenched as an essential component of healthcare services and delivery.

Evolution and refinement of the guideline development process continues with moves towards simplifying and reducing the human and financial cost of preparing guidelines without compromising integrity. In addition, the focus has shifted from guideline development to addressing the, as yet, unresolved challenge of guideline implementation.

The International Diabetes Federation (IDF)
The International Diabetes Federation (IDF) is an umbrella international non-governmental organization (NGO) of over 200 national diabetes associations in over 160 countries and has been leading the global diabetes community since 1950. IDF’s mission is to promote diabetes care, prevention, and a cure worldwide.

Approaches to guideline development

Developing guidelines is a time-consuming and costly process that is beyond the resources of many health-care systems. As the science of evidence-based medicine continues to evolve, there is now increasing questioning of the need for and the relevance of the traditional full guideline development process. In 2003, the IDF addressed this in its Guide for Guidelines10

which proposed two basic approaches:
_Full-Process
_ Derived

Complexity of decision-making in clinical management

Diabetes care is complex and involves a range of interventions – education, lifestyle modification (diet, physical activity), medications for diabetes complications prevention and treatment (eg, cardiovascular and renal disease), and ongoing monitoring and review (including self-monitoring blood glucose [SMBG], clinical [blood pressure and weight], and pathological [glycated hemoglobin, lipids, etc]). While multifactorial intervention has been shown to reduce morbidity and premature mortality,11 demonstrating the efficacy of individual components of care has been more difficult (eg, education,12 SMBG)

Guideline implementation
The translation of guidelines into everyday practice remains a vexed problem with little clear direction about what works best across all circumstances.

Ref: http://www.medicographia.com/2011/07/how-evidence-based-medicine-has-shaped-international-guidelines-over-the-past-25-years/