ADS Position Statements/Guidelines - Type 1 Diabetes Mellitus

Resources for Diabetes Health Professionals 

Utilising the Ambulatory Glucose Profile (AGP) combined with the Glucose Pattern Summary to support Clinical Decision Making in Diabetes Care

The ADS ‘AGP Plus’ Working Party Chair: Prof Stephen Twigg Members: A/Prof Neale Cohen, Ms Natalie Wischer, A/Prof Sof Andrikopoulos Summary An Australian Diabetes Society ‘Standardisation of AGP Profile Workshop’ was held on April 13th 2018, to identify the clinical effectiveness of glucose profiling in diabetes with a focus on retrospective, summary methods of reporting. This document reflects the main outcomes of that Consensus Workshop, leading to this consensus position statement with a practical focus. 
Consensus The Ambulatory Glucose Profile (AGP) enables retrospective analysis of dense data, trends and patterns for persons with diabetes and their health care team to help achieve appropriate glucose targets and to minimise hypoglycaemia and hyperglycaemia.

Download the 'ADS Consensus Position Statement on: Utilising the Ambulatory Glucose Profile (AGP) combined with the Glucose Pattern Summary to support Clinical Decision Making in Diabetes Care' - PDF (Posted: August, 2022)


ADS Primary Care Glucose Pattern Insights (GPI) Report Consensus Statement

Summary This Glucose Pattern Insights (GPI) report practical guide has been written to enable general practitioners to retrospective analyse data, trends and patterns arising from continuous and flash glucose monitors by people living with diabetes. The purpose is to educate and empower general practitioners to work with and enable people living with diabetes to achieve appropriate glucose targets and minimise hypoglycaemia and hyperglycaemia.  

Consensus Statement:  Please download the 'ADS Glucose Pattern Insights (GPI) Report in Primary Care - A Practical Guide' - PDF (Posted: 1 June, 2022)


Diabetes and Ramadan Position Statement

Authors: Sara Baqar, Jenny Sheen, Sofianos Andrikopoulos, Elif Ekinci

Summary: The Australian Diabetes Society has developed a position statement for the management of diabetes during Ramadan for people living with both type 1 diabetes and type 2 diabetes. Position Statement: Please download the joint full version of the 'ADS Diabetes and Ramadan Position Statement' - PDF (Posted: 11 April, 2022)


Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes: consensus statement of the ADS/ADEA/ADIPS/APEG Working Group

Authors: Anthony J Pease, Sofianos Andrikopoulos, Mary B Abraham, Maria E Craig, Brett Fenton, Jane Overland, Sarah price, David Simmons and Glynis P Ross

Summary
A consensus statement on 'Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes' was jointly developed by a working group from representatives of the Australian Diabetes Society (ADS), the Australian Diabetes Educators Society (ADEA), the Australasian Paediatric Endocrine Group (APEG), and the Australasian Diabetes in Pregnancy Society (ADIPS) that reflects a national approach to provide best practice across the lifespan for all people living with type 1 diabetes, should have equitable access to the most effective diabetes management systems, including technology where clinically appropriate, regardless of age or concessional status. As diabetes management technologies continue to evolve, so too must management strategies and health care systems. The consensus recommendations should be read in conjunction with the Australian Living Evidence Guidelines in Diabetes. 

MJA article: The ADS/ADEA/APEG/ADIPS Consensus Statement on 'Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes' can be viewed via the Medicial Journal of Australia (MJA) webpage at Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes: consensus statement of the ADS/ADEA/APEG/ADIPS Working Group | The Medical Journal of Australia (mja.com.au)(Published online: 21 June, 2021). Download the consensus statement MJA summary - PDF (Posted: 21 June, 2021)

Consensus Statement
Please download the joint full version of the ADS/ADEA/APEG/ADIPS Consensus Statement on 'Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes' - PDF (Posted: 21 June, 2021). Please visit the Australian Living Evidence Guidelines in Diabetes webpage at ADS- Living Evidence Guidelines in Diabetes


Use of "Biosimilar" Insulins for Diabetes 

Summary
This Position Statement represents the collective views of the Australian Diabetes Society, the Australian Diabetes Educators Association and Diabetes Australia.

The Therapeutic Goods Administration (TGA) recently approved the first “biosimilar” insulin product for use in Australia – Basaglar Insulin. A “biosimilar” is a copy of a biological molecule that has already been approved for use and has a demonstrated similarity in physiological characteristics, efficacy and safety.

 

Position Statement
Download the full version of the 'Use of “biosimilar” Insulins for Diabetes Position Statement' - PDF (Updated: June, 2019)


Emergency Management of Hyperglycaemia in Primary Care

Summary
Emergency management of hyperglycaemia in primary care was developed by the RACGP and the Australian Diabetes Society (ADS) to raise clinical awareness of hyperglycaemic emergencies in primary care by:

This document should be read in conjunction with the relevant management flow charts (Figures 1 and 2), which provide information for the management of hyperglycaemic emergencies before patients arrive at hospital. This position statement should integrate with, but not replace, existing sick day, ambulance and hospital-based management protocols. Clinicians should consult existing local/regional or health pathways/protocols for inpatient management.

It is important to note this statement does not replace existing diagnostic guidelines for routine (non-emergency) presentations, and should not be used for evaluating hyperglycaemia associated with pregnancy where specialist advice on assessment and management must be sought. 

Position Statement
Download the jointly-produced RACGP and Australian Diabetes Society clinical Position Statement which aims to assess and manage hyperglycaemic emergencies and prevent adverse outcomes - PDF (Posted: May, 2018)


Insulin Glargine (Lantus ®) and a Possible Link with Cancer

Position Statement
Download the full version of the 'ADS Position Statement on Insulin Glargine (Lantus®) and a Possible Link with Cancer - PDF (Posted: October, 2017)


Insulin-requiring Diabetes and Recreational Diving

Authors: Mervyn Kyi, Barbora Paldus, Natalie Nanayakkara, Michael Bennett, Rebecca Johnson, Catherine Meehan, Peter Colman

Summary
In 2015 the Australian Diabetes Society commissioned a working group to review and revise its position statement on scuba diving in persons with diabetes. The working group consisted of endocrinologists with an interest in type 1 diabetes, diving medical specialists, a recreational diver with diabetes and an advocate for people with type 1 diabetes. A thorough literature review was performed and all available evidence was summarised and a new position statement was drafted. The new position statement was submitted to the ADS Council for approval. The scope of this document is restricted to recreational (not professional) diving in line with the available evidence. It is also targeted at insulin-requiring (both type 1 and type 2) diabetes, as traditionally this group has been excluded from recreational diving. This document updates the ADS position statement in line with current evidence.

Position Statement
Download the full version of the 'Insulin-requiring diabetes and recreational diving ADS Position Statement' - PDF and Appendices - PDF (Posted: December, 2016)


HbA1c for Diagnosis of Diabetes Mellitus

Summary
Guidance concerning the use of glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus Position Statement

The use of glycated haemoglobin (HbA1c) for diagnosis of diabetes mellitus has been accepted by Medicare for reimbursement. The position statement "Guidance concerning the use of glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus" has also been published in the MJA on 20 July 2015. Click here to view the document in MJA.(https://www.mja.com.au/journal/2015/203/2/guidance-concerning-use-glycated-haemoglobin-hba1c-diagnosis-diabetes-mellitus)

Like any test, the use of HbA1c for the diagnosis of diabetes mellitus has its strengths and weaknesses. It is important for practitioners to be aware of its potential short comings as well as correctly interpreting a positive and a negative result. The aim of this position paper is to provide a succinct summary of how to optimally use the test to diagnose patients. The test represents an important advance and it is hoped that the guidance provided by this position statement will assist health practitioners to use the test effectively.

Position Statement
Download the full version of the 'Guidance concerning the use of glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus ADS Position Statement' - PDF (Posted: July, 2015)

Download the Press Release Statement on 'Guidance concerning the use of glycated haemoglobin (HbA1c) for the diagnosis of diabetes mellitus ADS Position Statement' - PDF (Posted: July, 2015)

View and download the new HbA1c Conversion Table

ADS Recommendations for the use of HbA1c for the Diagnosis of Diabetes

HbA1c is now acceptable as a diagnostic test for diabetes. The threshold for diagnosis is at an HbA1c level of 6.5%. The existing glucose criteria for the diagnosis of diabetes remain valid as well.

The criteria for the diagnosis of diabetes are now:

In an asymptomatic patient the test should be repeated for confirmation of the result and diagnosis. An abnormal result on 2 different diagnostic tests is also acceptable. For full details of the recommendation of HbA1c for the diagnosis of diabetes, including situations where the HbA1c is unreliable, go to https://www.mja.com.au/journal/2012/197/4/role-hba1c-diagnosis-diabetes-mellitus-australia.


ADS Guidelines for Routine Glucose Control In Hospital

Summary
The 2012 ADS Guidelines for Routine Glucose Control in Hospital have been developed over the last year, and cover a range of areas including general hospital wards, myocardial infarction, stroke, steroid-induced hyperglycaemia, enteral and parenteral feeding, insulin pump therapy, end of life situations, the optimal means for achieving glucose control, routine measures in hospital, and how to follow-up patients with newly discovered hyperglycaemia. The guidelines were informed by systematic reviews and evidence where there was any; otherwise they were based on consensus.

The Writing Party comprised David Chipps, Shirley Cornelius, Barbara Depczynski, Kristine Heels, David O’Neal, Jennifer Wong, Sophia Zoungas, and Wah Cheung.

Position Statement
Download the ADS Guidelines for Routine Glucose Control in Hospital - PDF (Posted: 2012)


National Evidence Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults

Summary The Australian Diabetes Society (ADS) and the Australasian Paediatric Endocrine Group (APEG) have completed the National Evidence Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults and is approved by the NHMRC under section 14A of the National Health and Medical Research Council Act 1992.

Guidelines Download the National Evidence Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults - PDF

Download the National Evidence Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults (Technical Report) - PDF

Download the National Evidence Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults (Press Release Document) - PDF

(Please Note: Only electronic PDF copies are available - Posted 2011)


ADS Peri-Operative Diabetes Management Guidelines

Summary
These guidelines have been developed by an ADS working group and are primarily intended to provide assistance for those practitioners whose primary focus is not diabetes or who do not have the support of local diabetes expertise in their management of patients with diabetes undergoing surgical procedures. 

Position Statement
Download the ADS Peri-operative Diabetes Management Guidelines - PDF (Posted: July, 2012)


ADS Position Statement on the Individualisation of HbA1c targets for Adults with Diabetes Mellitus

Summary
The Australian Diabetes Society has produced a Position Statement regarding the individualization of HbA1c targets, for adults with diabetes mellitus. This has been published in the Medical Journal of Australia, in the issue of September 21, 2009. A more comprehensive document with further background documentation can also be downloaded here and you can read the MJA article online.


Prediabetes: A Position Statement from the ADS & ADEA

Posted: May, 2007 You can read the MJA article online.