Management of Non‐insulin‐dependent Diabetes Mellitus in Europe: A Concensus View

Abstract
Non-insulin-dependent diabetes mellitus (NIDDM) is a very common disorder, but less attention is paid to it than to the more dramatic but less prevalent insulin-dependent diabetes. The majority of patients receive their care from primary health care physicians or doctors without particular training in diabetes. Care is highly variable and often inadequate. In the USA this problem has been tackled by promoting a national education programme involving extensive use of television together with written guidelines for management. These latter have been looked at with interest by many diabetologists in Europe, but it has been felt that the guidelines were not entirely suitable for European practice. As a result an initiative was taken to generate more suitable materials for European use. Diabetologists from 14 European countries, representing the European NIDDM Policy Group (EUR-NIDDM-PC) therefore met in Amsterdam in 1986 with the blessing of the Council of the European Region of the IDF. The aims were first to establish whether a concensus view on management of non-insulin-dependent diabetes could be achieved, and if this was possible then to produce written materials for use in the care of people with non-insulin-dependent diabetes aimed particularly at the primary health care sector and the general physician. A remarkable degree of concensus was reached considering the different backgrounds and specialities represented by the group. Discussions were lengthy but constructive and were pervaded by a determination to improve care for such patients in Europe. The first output from the group is the short concensus document which follows. This has already been published in the IDF Bulletin but is now reproduced in full in Diabetic Medicine in order to broaden the readership of the document. It is meant as a discussion paper. As such it was presented at a meeting of diabetologists in Berlin in September 1987 and was amended as a result of these discussions. Further comments and input will be welcome. Once such comments have been received the group will produce a desk-top manual for physicians together with a more comprehensive volume discussing the problems of non-insulin-dependent diabetes.