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- Samuel J Westall, Ram Prakash Narayanan, Simon Watmough, Greg Irving, Niall Furlong, Sid McNulty, Sumudu Bujawansa, and Kevin Hardy.
- St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens, UK and Edge Hill University, Ormskirk, UK sam.westall@nhs.net.
- Clin Med (Lond). 2022 May 1; 22 (3): 257265257-265.
BackgroundEvidence and guidelines increasingly support an individualised approach to care for people with type 2 diabetes and individualisation of glycaemic targets in response to patient factors.MethodsWe undertook a scoping review of the literature for evidence of factors impacting upon glycated haemoglobin target individualisation in adults with type 2 diabetes. Data were analysed thematically with the themes inductively derived from article review.FindingsEvidence suggests that presence of cardiovascular disease, hypoglycaemia unawareness, severe hypoglycaemia, limited life expectancy, advanced age, long diabetes duration, frailty, cognitive impairment, disability, extensive comorbidity, diabetes distress and patient preference should inform the setting of glycaemic targets.ConclusionThe management of people with diabetes is complex. In clinical practice, many patients will have a variety of factors that should be considered when personalising their care. Approaches to personalised care and glycaemic treatment targets should be undertaken as part of a shared decision-making process between physician and patient. Use of electronic records might enable greater efficiency and more widespread use of personalised care plans for people with diabetes.© Royal College of Physicians 2022. All rights reserved.
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