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Clinical Practice Guideline for Diagnosis, Treatment and Follow-Up of Diabetes Mellitus and Its Complications - 2019

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Clinical Practice Guideline for Diagnosis, Treatment and Follow-Up of Diabetes Mellitus and Its Complications - 2019 THE SOCIETY of ENDOCRINOLOGY and METABOLISM of TURKEY (SEMT) Clinical Practice Guideline for Diagnosis, Treatment and Follow-up of Diabetes Mellitus and Its Complications - 2019 English Version of the 12th Edition SEMT Diabetes Mellitus Working Group ISBN: 978-605-4011-39-1 CLINICAL PRACTICE GUIDELINE FOR DIAGNOSIS, TREATMENT, AND FOLLOW-UP OF DIABETES MELLITUS AND ITS COMPLICATIONS-2019 © SEMT -2019 This material has been published and distributed by The Society of Endocrinology and Metabolism of Turkey (SEMT). Whole or part of this guideline cannot be reproduced or used for commercial purposes without permission. THE SOCIETY of ENDOCRINOLOGY and METABOLISM of TURKEY (SEMT) Meşrutiyet Cad., Ali Bey Apt. 29/12, Kızılay 06420, Ankara, Turkey Phone. +90 312 425 2072 http://www.temd.org.tr ISBN: 978-605-4011-39-1 English Version of the 12th Edition Publishing Services BAYT Bilimsel Araştırmalar Basın Yayın ve Tanıtım Ltd. Şti. Ziya Gökalp Cad. 30/31 Kızılay 06420, Ankara, Turkey Phone. +90 312 431 3062 Fax +90 312 431 3602 www.bayt.com.tr Printing Miki Matbaacılık San. ve Tic. Ltd. Şti. Matbaacılar Sanayi Sitesi 1516/1 Sk. No. 27 İvedik, Yenimahalle / Ankara, Turkey Phone. +90 312 395 2128 Print Date: October 23, 2019 “Major achievements and important undertakings are only possible through collaborations” “Büyük işler, mühim teşebbüsler; ancak, müşterek mesai ile kabil-i temindir.” MUSTAFA KEMAL ATATÜRK, 1925 PREFACE Dear colleagues, The prevalence of diabetes has been increasing tremendously in the last few decades. As a result , medical professionals/ specialists from different fields encounter many diabetics in their daily practice. At this point, updated guidelines on diabetes management, which take regional specification into consideration is needed. “The Clinical Practice Guideline for Diagnosis, Treatment, and Follow-up of Diabetes Mellitus and Its Complications” updated in August 2019 by Diabetes Mellitus Working Group of “the Society of Endocrinology and Metabolism of Turkey” (SEMT) will be a response to this need. It’s content is enriched with latest literature and SEMT Recommendations. These recommendations make it very practical. We are grateful to the dedicated group members who put a lot of effort and time in this task. On behalf of SEMT Executive Committee Füsun SAYGILI, MD President SEMT Clinical Practice Guideline for Diabetes-2019 | 5 INTRODUCTION Esteemed colleagues, We are proud and excited to present you with the English translation of “Clinical Practice Guideline for Diagnosis, Treatment, and Follow-up of Diabetes Mellitus and Its Complications”. This guideline is regularly prepared under the light of current global guidelines and based on the facts of our country. The journey started in 2006, and to date, our guideline become a reference book for many of our colleagues in Turkey. In previous years, the revision was done annually, with the accelerated accumulation of scientific data, there has been a need to update twice a year since 2018. First English translation was pressed in 2010 as a supplement of Turk-JEM (Turkish Journal of Endocrinology and Metabolism), and as the 2nd one, the current product is the translation of the 12th Turkish version. The aim of publishing an English translation is to present our point of view as Turkish physicians interested in diabetes and to share the data of our country on the international platform. We hope that this work will be helpful to all our colleagues interested in diabetology, especially in countries around Turkey, and in the regions where the number of Turkish residents is high. On behalf of the SEMT Diabetes Guideline-2019 Writing Committee Serpil SALMAN İlhan SATMAN SEMT Clinical Practice Guideline for Diabetes-2019 | 7 WRITING COMMITTEE of SEMT CLINICAL PRACTICE GUIDELINE FOR DIAGNOSIS, TREATMENT, AND FOLLOW-UP OF DIABETES MELLITUS AND ITS COMPLICATIONS-2019 Ilhan SATMAN, MD Candeger YILMAZ, MD Serpil SALMAN, MD Sema AKALIN, MD Sazi IMAMOGLU, MD Yuksel ALTUNTAS, MD Nevin DINCCAG, MD Fırat BAYRAKTAR, MD Ibrahim DEMIRCI, MD Zeynep OSAR SIVA, MD Oguzhan DEYNELI, MD Volkan YUMUK, MD Y. Alper SONMEZ, MD Ilhan TARKUN, MD Dilek YAZICI, MD Berrin CETINARSLAN, MD Serdar GULER, MD Emel OZER, RD Nese SALTOGLU, MD Selcuk BAKTIROGLU, MD Selim BADUR, MD Samil AKTAS, MD Reyhan ERSOY, MD Meral MERT, MD Nurdan GUL, MD Mine ADAS, MD Sema CIFTCI DOGANSEN, MD Didem OZDEMIR, MD Bengusu MIRASOGLU, MD Fatih KILICLI, MD Fulya CALIKOGLU, MD Sinem KIYICI, MD Ramazan CAKMAK, MD Ayse Nur IZOL TORUN, MD Ummu MUTLU, MD Ayse KUBAT UZUM, MD Goktug SARIBEYLILER, MD Ozlem SOYLUK SELCUKBIRICIK, MD Ayse Merve CELIK, MD Gulsah YENIDUNYA YALIN, MD Cemile IDIZ, RD Selda GEDIK CELIK, RN Elif BAGDEMIR, RN ENGLISH VERSION Redaction editors Oğuzhan DEYNELI, MD Serpil SALMAN, MD Nilgün GUVENER DEMIRAG, MD Ilhan SATMAN, MD Cem HAYMANA, MD Sazi IMAMOGLU, MD Redaction committee Ayşe KUBAT UZUM, MD Mine ADAŞ, MD Meral MERT, MD Sema AKALIN, MD Taner BAYRAKTAROGLU, MD Didem OZDEMIR, MD Selvihan BEYSEL, MD Alper SONMEZ, MD Fulya CALIKOGLU, MD İlhan TARKUN, MD İbrahim DEMIRCI, MD Dilek YAZICI, MD *Sorted by alphabetical order of last names. CONFLICT OF INTEREST Authors in the Writing Committee of “SEMT Clinical Practice Guideline for Diagnosis, Treatment, and Follow-up of Diabetes Mellitus and Its Complications-2019” declared no commercial conflict of Interest with any company or group during the preparation, writing and printing of the guideline. Note: “Medical Nutrition Therapy in Diabetes” section has been prepared by “Dietitians Society for Diabetes” and coordinated by Emel OZER. 8 | SEMT Clinical Practice Guideline for Diabetes-2019 COLLEAGUES CONTRIBUTED TO THE PREPARATION OF PREVIOUS EDITIONS Fettah ACIBUCU, MD Cihangir EREM, MD Ufuk OZUGUZ, MD Gungor AKCAY, MD Canan ERSOY, MD Mucahit OZYAZAR, MD Yalcın ARAL, MD Halil Onder ERSOZ, MD Fulden SARAC, MD Mustafa ARAZ, MD Sibel ERTEK, MD Fusun SAYGILI, MD Metin ARSLAN, MD Melek Eda ERTORER, MD Hadi SELIMOGLU, MD Mehmet ASIK, MD Erdinc ERTURK, MD Murat SERT, MD Hayati AYAKTA, MD Olcay GEDIK, MD Tumay SOZEN, MD Yusuf AYDIN, MD Cumali GOKCE, MD Numan TAMER, MD Goksun AYVAZ, MD Mustafa Sait GONEN, MD Refik TANAKOL, MD Omer AZAL, MD Nese Ersöz GULCELIK, MD Seher TANRIKULU, MD Nazif BAGRIACIK, MD Sevim GULLU, MD Sakin TEKIN, MD Mitat BAHCECI, MD Sadi GUNDOGDU, MD Tamer TETIKER, MD Mustafa Kemal BALCI, MD Engin GUNEY, MD Melek TEZCAN, MD Nilgun BASKAL, MD Kagan GUNGOR, MD Akın Savas TOKLU, MD Fahri BAYRAM, MD Alper GURLEK, MD Fusun BALOS TORUNER, MD Dilek BERKER, MD Hulya HACISAHINOGULLARI, MD Armagan TUGRUL, MD Erol BOLU, MD Leyla IRAK, MD Ercan TUNCEL, MD Bulent CAN, MD Serhat ISIK, MD Neslihan BASCIL TUTUNCU, MD Selcuk CAN, MD Hasan ILKOVA, MD Yasemin TUTUNCU, MD Zeynep CANTURK, MD Taylan KABALAK, MD Mehmet Ali UCAR, MD Mustafa CESUR, MD Hakkı KAHRAMAN, MD Kubilay UKINC, MD Erman CAKAL, MD Züleyha Cihan KARACA, MD Alper USLUOGULLARI, MD Bekir CAKIR, MD Ayhan KARAKOC, MD Ali Rıza UYSAL, MD Ilkay CAKIR, MD Kubilay KARSIDAG, MD Gunalp UZUN, MD Nuri CAKIR, MD Fahrettin KELESTEMUR, MD Gokhan UCKAYA, MD Sevki CETINKALP, MD Bekir KESKINKILIC, MD Ilhan YETKIN, MD Ramis COLAK, MD Fatih KILICLI, MD Murat YILMAZ, MD Ahmet CORAKCI, MD Onder KILICOGLU, MD Abdurrahman COMLEKCI, MD Sinem KIYICI, MD Cavit CULHA, MD Mehmet Sait KOC, MD Selcuk DAGDELEN, MD Mustafa KUTLU, MD Taner DAMCI, MD Faruk KUTLUTURK, MD Fikret DEMIR, MD Ferit Kerim KUCUKLER, MD Ferhat DENIZ, MD Turkan METE, MD Hatice Karakose DOGAN, MD Mesut MUTLUOGLU, MD Hatice Sebila DOKMETAS, MD Aslı NAR, MD Belgin EFE, MD Mustafa Oral ONCUL, MD Gulsah ELBUKEN, MD Gokhan OZISIK, MD Tomris ERBAS, MD Mesut OZKAYA, MD Gurbuz ERDOGAN, MD Mine OZTURK, MD SEMT Clinical Practice Guideline for Diabetes-2019 | 9 CLASSIFICATION OF EVIDENCE-BASED MEDICAL INFORMATION TABLE 1: Evidence system used in this guideline Level of evidence Description q Definitive evidence obtained from the following randomized controlled trials with sufficiently powerful design, good execution and data that can be generalized. Multi-center studies Meta-analyses with quality assessment performed q Inevitable evidence obtained from nonexperimental studies like A “all or nothing” rule developed by Oxford University Centre for Evidence-Based Medicine q Supporting evidence obtained from the following randomized controlled trials with sufficiently powerful design and well execution: Studies carried out in one or more institutions Meta-analyses with quality assessment performed q Supportive evidence obtained from the following well-conducted cohort studies: Prospective cohort or record studies B Meta-analyses of cohort studies q Supportive evidence obtained from well-conducted case-control studies q Supportive evidence obtained from insufficiently controlled or uncontrolled studies Randomized clinical trials with one or more major or three or more minor faults that may affect the verification of the results C Observational studies with high bias probability (e.g., comparison of case series and historical control cases) Case series or case reports q Evidence contradicting with the weight of the evidence supporting the hypothesis D q Evidence based on expert opinion or clinical experience 10 | SEMT Clinical Practice Guideline for Diabetes-2019 CONTENTS PREFACE 5 INTRODUCTION 7 WRITING COMMITTEE 8 ENGLISH VERSION 9 COLLEAGUES CONTRIBUTED TO THE PREPARATION OF PREVIOUS EDITIONS 9 CLASSIFICATION OF EVIDENCE-BASED MEDICAL INFORMATION 10 01 DIAGNOSIS, CLASSIFICATION AND SCREENING IN GLYCEMIC DISORDERS 15 1.1. | DEFINITION 15 1.2. | DIAGNOSTIC CRITERIA AND CLASSIFICATION 15 1.3. | TYPE 1 DIABETES MELLITUS 22 1.4. | TYPE 2 DIABETES MELLITUS 23 1.5. | GESTATIONAL DIABETES MELLITUS 25 1.6. | SPECIFIC TYPES OF DIABETES 25 1.7. | SCREENING AND DIAGNOSTIC TESTS 26 02 STANDARDS OF CARE FOR PATIENTS WITH DIABETES 33 2.1. | ANAMNESIS 34 2.2. | PHYSICAL EXAMINATION 34 2.3. | CONSULTATIONS 35 2.4. | LABORATORY EXAMINATIONS AND ROUTINE FOLLOW-UP 35 2.5. | COMPLICATIONS 38 2.6. | EDUCATION 40 2.7. | ROUTINE PARAMETERS OF DIABETES MONITORING 41 03 PRINCIPLES OF HOSPITALIZATION IN PATIENTS WITH DIABETES 43 3.1.
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