PMID- 36793876 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231106 IS - 2296-858X (Print) IS - 2296-858X (Electronic) IS - 2296-858X (Linking) VI - 10 DP - 2023 TI - Development process of a clinical guideline to manage type 2 diabetes in adults by Ayurvedic practitioners. PG - 1043715 LID - 10.3389/fmed.2023.1043715 [doi] LID - 1043715 AB - BACKGROUND: Type 2 diabetes mellitus (T2DM), a common chronic health condition, has major health and socioeconomic consequences. In the Indian subcontinent, it is a health condition for which individuals commonly consult Ayurvedic (traditional medical system) practitioners and use their medicines. However, to date, a good quality T2DM clinical guideline for Ayurvedic practitioners, grounded on the best available scientific evidence, is not available. Therefore, the study aimed to systematically develop a clinical guideline for Ayurvedic practitioners to manage T2DM in adults. METHODS: The development work was guided by the UK's National Institute for Health and Care Excellence (NICE) manual for developing guidelines, the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. First, a comprehensive systematic review was conducted which evaluated Ayurvedic medicines' effectiveness and safety in managing T2DM. In addition, the GRADE approach was used for assessing the certainty of the findings. Next, using the GRADE approach, the Evidence-to-Decision framework was developed, and we focused on glycemic control and adverse events. Subsequently, based on the Evidence-to-Decision framework, a Guideline Development Group of 17 international members made recommendations on Ayurvedic medicines' effectiveness and safety in T2DM. These recommendations formed the basis of the clinical guideline, and additional generic content and recommendations were adapted from the T2DM Clinical Knowledge Summaries of the Clarity Informatics (UK). The feedback given by the Guideline Development Group on the draft version was used to amend and finalize the clinical guideline. RESULTS: A clinical guideline for managing T2DM in adults by Ayurvedic practitioners was developed, which focuses on how practitioners can provide appropriate care, education, and support for people with T2DM (and their carers and family). The clinical guideline provides information on T2DM, such as its definition, risk factors, prevalence, prognosis, and complications; how it should be diagnosed and managed through lifestyle changes like diet and physical activity and Ayurvedic medicines; how the acute and chronic complications of T2DM should be detected and managed (including referral to specialists); and advice on topics like driving, work, and fasting including during religious/socio-cultural festivals. CONCLUSION: We systematically developed a clinical guideline for Ayurvedic practitioners to manage T2DM in adults. CI - Copyright (c) 2023 Chattopadhyay, Kapoor, Heinrich, Mitra, Mittal, Lewis, Greenfield, Mukherjee, Pischel, Jeemon, Tandon, Kinra, Biswas and Leonardi-Bee. FAU - Chattopadhyay, Kaushik AU - Chattopadhyay K AD - Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom. AD - The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom. FAU - Kapoor, Nitin AU - Kapoor N AD - Department of Endocrinology, Metabolism and Diabetes, Christian Medical College, Vellore, India. AD - Non-communicable Diseases and Implementation Science, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia. FAU - Heinrich, Michael AU - Heinrich M AD - Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University College London, London, United Kingdom. FAU - Mitra, Achintya AU - Mitra A AD - Central Ayurveda Research Institute Under Central Council for Research in Ayurvedic Sciences (Ministry of Ayush), Kolkata, India. FAU - Mittal, Madhukar AU - Mittal M AD - Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur, India. FAU - Lewis, Sarah Anne AU - Lewis SA AD - Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom. FAU - Greenfield, Sheila Margaret AU - Greenfield SM AD - Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom. FAU - Mukherjee, Shyamalendu AU - Mukherjee S AD - West Bengal State Medicinal Plants Board, Kolkata, India. FAU - Pischel, Ivo AU - Pischel I AD - Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University College London, London, United Kingdom. FAU - Jeemon, Panniyammakal AU - Jeemon P AD - Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. FAU - Tandon, Nikhil AU - Tandon N AD - Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India. FAU - Kinra, Sanjay AU - Kinra S AD - Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom. FAU - Biswas, Tuhin Kanti AU - Biswas TK AD - Department of Kayachikitsa, J. B. Roy State Ayurvedic Medical College and Hospital, Kolkata, India. AD - West Bengal Ayurvedic Practitioners Association (Paschimbanga Ayurved Chikitsak Samity), Kolkata, India. FAU - Leonardi-Bee, Jo AU - Leonardi-Bee J AD - Lifespan and Population Health Academic Unit, School of Medicine, University of Nottingham, Nottingham, United Kingdom. AD - The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom. LA - eng GR - WT_/Wellcome Trust/United Kingdom GR - MR/T003537/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article DEP - 20230130 PL - Switzerland TA - Front Med (Lausanne) JT - Frontiers in medicine JID - 101648047 PMC - PMC9922832 OTO - NOTNLM OT - Ayurveda OT - clinical guideline OT - development OT - management OT - type 2 diabetes mellitus COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/02/17 06:00 MHDA- 2023/02/17 06:01 PMCR- 2023/01/30 CRDT- 2023/02/16 02:22 PHST- 2022/09/13 00:00 [received] PHST- 2023/01/12 00:00 [accepted] PHST- 2023/02/16 02:22 [entrez] PHST- 2023/02/17 06:00 [pubmed] PHST- 2023/02/17 06:01 [medline] PHST- 2023/01/30 00:00 [pmc-release] AID - 10.3389/fmed.2023.1043715 [doi] PST - epublish SO - Front Med (Lausanne). 2023 Jan 30;10:1043715. doi: 10.3389/fmed.2023.1043715. eCollection 2023.