SynthesisDiabetes care2018
Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries-A Systematic Review.
Synthesis in Diabetes care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Global, regional, and national cascades of diabetes care, 2000-23: a systematic review and modelling analysis using findings from the Global Burden of Disease Study.The lancet. Diabetes & endocrinology · 2025Pooled it
- Clinical care in interstitial lung disease: a critical appraisal of clinical guidance documents.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Diabetes medication management recommendations for older adults: A systematic review of the Western Pacific region.Geriatrics & gerontology international · 2025Pooled it
- Inclusion of Rurality and Social Determinants of Health in Documents for the Primary Prevention of Type 2 Diabetes: A Systematic Review.Metabolic syndrome and related disorders · 2024Pooled it
- Randomised controlled trials on prevention, diagnosis and treatment of diabetes in African countries: a systematic review.BMJ open · 2022Pooled it
- Quality of stroke guidelines in low- and middle-income countries: a systematic review.Bulletin of the World Health Organization · 2021Pooled it
- Lifestyle Interventions to Improve Glycemic Control in Adults with Type 2 Diabetes Living in Low-and-Middle Income Countries: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCTs).International journal of environmental research and public health · 2021Pooled it
- Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis.PLoS medicine · 2020Pooled it
- Development and implementation of guidelines for the management of depression: a systematic review.Bulletin of the World Health Organization · 2020Pooled it
- Digital messaging to support control for type 2 diabetes (StAR2D): a multicentre randomised controlled trial.BMC public health · 2021Trial
- Nutrition transitions, obesity and T2DM in the Middle East and North Africa.Nature reviews. Endocrinology · 2026Review
- Health System Integration and Equity in Type 2 Diabetes Prevention: A Comparative Policy Analysis of Seven National Guidelines.Journal of evaluation in clinical practice · 2026Article
- Delphi consensus validation of an integrated climate sensitive diabetes management model for climate vulnerable health systems in Iran.Scientific reports · 2026Article
- The psychological burden of diabetes: common mental health disorders, their impact on disease outcomes and strategies for intervention.Journal of diabetes and metabolic disorders · 2026Review
- Study Protocol for the Development of an African Framework for Critical Care Nursing Based on Ubuntu Using Participatory Cooperative Inquiry: Decolonising Care.Nursing in critical care · 2026Article
- Addressing Unmet Needs in the Management of Diabetes in Asia and Enhancing Diabetes Care Through the Use of Digital Technology: An Expert Opinion.Journal of the ASEAN Federation of Endocrine Societies · 2026Review
- Type 2 diabetes mellitus.Nature reviews. Disease primers · 2026Review
- Younger Age is Associated with Treatment and Complication Outcomes Among Type 2 Diabetes Mellitus Patients in Kigali University Teaching Hospital.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Global challenges in diabetes research and care: which way forward? An appraisal from the EASD Global Council.Diabetologia · 2025Review
- Pathway to developing paediatric non-communicable disease guidelines in Malawi: a scoping review.BMC health services research · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
33 authors.
Funding
Abstract
objectiveThe extent to which diabetes (DM) practice guidelines, often based on evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND
methodsEligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences.
resultsMost LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination plan as well as socioeconomic and ethical-legal contextualization. LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines (
conclusionsA new approach to the contextualization, content development, and delivery of LMIC guidelines is needed to improve outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.