Diabetes is a serious chronic condition that requires ongoing management. The Diabetes Australia Treatment Algorithm (DAT) is a comprehensive guide that provides evidence-based recommendations for the management of diabetes. It is designed to help health professionals, such as doctors, nurses, dieticians and diabetes educators, who are responsible for the care of people with diabetes.
The algorithm was first developed in 1999 by the Diabetes Australia Research Foundation and the Australian Diabetes Society. It has since been updated and revised to reflect the latest evidence and clinical practice standards. The algorithm provides guidance in the areas of diabetes screening, diagnosis, assessment and management. It includes information on lifestyle modification and medical therapy for both type 1 and type 2 diabetes.
Screening for Diabetes
Screening for diabetes is recommended for adults aged 40 and over, as well as those with risk factors such as obesity, family history of diabetes, or certain ethnic backgrounds. Screening for diabetes should also be considered for adults aged 30 and over if they have additional risk factors such as high blood pressure, high cholesterol, or a history of gestational diabetes.
The recommended screening test for diabetes is a fasting plasma glucose test. This test measures the amount of glucose in the blood after a person has not eaten anything for at least eight hours. The test should be done twice, at least two weeks apart. If the results of both tests are higher than normal, it is likely that a person has diabetes.
Diagnosis of Diabetes
Diabetes is diagnosed when a fasting plasma glucose test is greater than or equal to 7.0 mmol/L. The diagnosis can also be made when a random plasma glucose test (taken at any time during the day) is greater than or equal to 11.1 mmol/L, or when a person has symptoms of diabetes and a plasma glucose test is greater than or equal to 11.1 mmol/L.
It is important to note that a person may have diabetes even if their fasting plasma glucose test results are lower than 7.0 mmol/L. This is because some people have what is known as “impaired fasting glucose”, which means their blood glucose levels are elevated but not high enough to meet the diagnostic criteria for diabetes.
Assessment of Diabetes
Once a person has been diagnosed with diabetes, their health care provider should assess their risk factors for developing diabetes-related complications. This includes assessing the person’s current lifestyle, medical history, family history, and risk factors for cardiovascular disease, such as high blood pressure and smoking.
The health care provider should also assess for signs and symptoms of diabetes-related complications, such as retinopathy (eye damage), neuropathy (nerve damage), and nephropathy (kidney damage). The health care provider should also assess a person’s risk of hypoglycemia (low blood sugar), which can be caused by medications or lifestyle factors.
Management of Diabetes
Once a person has been assessed for diabetes, their health care provider should develop a management plan that is tailored to their individual needs. This plan should include lifestyle modifications such as healthy eating, physical activity, and weight management. It should also include medical therapies such as insulin, oral medications, and other medications as appropriate.
The health care provider should monitor the person’s progress regularly and adjust the treatment plan as necessary. The health care provider should also provide ongoing education and support for the person with diabetes to help them manage their condition and prevent the development of complications.
Conclusion
The Diabetes Australia Treatment Algorithm is a comprehensive guide to the screening, diagnosis, assessment and management of diabetes. It provides evidence-based recommendations for health professionals who are responsible for the care of people with diabetes. The algorithm is designed to help health professionals develop individualised treatment plans for people with diabetes that are tailored to their individual needs.
The algorithm should be used in conjunction with clinical judgement and other evidence-based guidelines. It is important to note that the algorithm is not a substitute for the judgement of a health care provider and should not be used to replace individualised care.
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