Aled Roberts our Course Director for Diabetes tells us how he has co-authored some important guidelines on the management of specific inpatient situations for people with diabetes.
“The Joint British Diabetes Societies Inpatient writing (JBDS-IP) write guidelines for the management of specific inpatient situations for people with diabetes. JBDS-IP have now produced eight guidelines including the management of diabetic ketoacidosis, peri operative management of diabetes and management of hyperglycaemic hyperosmolar state. I have been representing the Welsh Endocrine and Diabetes Society (WEDS) on the JBDS-IP writing group and was the lead author of the enteral feeding guideline. Last year the group decided to produce guidance on the management of steroids in people with diabetes. I agreed to co-author this guideline along with June James a Diabetes specialist Nurse from Leicester and Dr Ketan Dhatariya from Norwich.
The aim of the guideline is to provide advice to non-Diabetologists commencing steroids in people with Diabetes, but also to outline a recommended response to those people who develop diabetes whilst receiving steroid treatment. Necessarily the guidance gives advice for patients leaving hospital on steroids and could be extrapolated to steroids commenced in the outpatient clinic and in general practice. The production of this guidance, as with many of the areas covered by the JBDS-IP documents, was produced without the benefit of a strong evidence base. We thus set about asking diabetes teams from around the United Kingdom to share their local guidance. We collected a large number of guidelines and these, together with a literature search in the area, helped us to produce a draft guideline. We fine tuned this guideline in committee, and then circulated it to the stakeholders of JBDS-IP. These stakeholders include the professional committee of Diabetes UK, TREND-UK, and the Primary Care Diabetes Society.
Writing guidelines can be a political process, more so when the guidance covers an area which is relatively devoid of good quality evidence to guide practice. However, we feel that we have created a guideline which is pragmatic and user-friendly, and relevant to general physicians and specialists such as haematologists, neurologists and respiratory physicians who would utilise steroids in their practice. I commend these guidelines to you – they can be found here:
Tell us if you have written guidelines for your speciality? We might even write a feature blog about you.