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International Journal of Endocrinology
Volume 2015, Article ID 519032, 11 pages
Review Article

Critical Appraisal of International Guidelines for the Management of Diabetic Neuropathy: Is There Global Agreement in the Internet Era?

Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Received 24 December 2014; Revised 2 March 2015; Accepted 18 March 2015

Academic Editor: Janaka Karalliedde

Copyright © 2015 Mingfang Sun et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. The management of diabetic neuropathy (DN) can be challenging. There exist many guidelines for DN management, but the quality of these guidelines has not been systematically evaluated or compared. The objective of our study was to assess the quality of these guidelines as a step toward their future optimization, the development of international guidelines, and, ultimately, the improvement of the care process. Methods. Relevant data were selected to identify international guidelines. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was used to evaluate the quality of the selected guidelines. In addition, the reviewers summarized and compared all of the recommendations from the included guidelines for DN’s management. Results. Thirteen guidelines were included after the selection process. According to AGREE II, few guidelines scored well for all three aspects of DN management. Detailed comparisons revealed that these guidelines provide inconsistent recommendations, making it difficult for diabetes clinicians to choose appropriate guideline. Conclusions. The quality of most guidelines for the management of DN should be improved. Further studies should concentrate on developing internationally accepted and evidence-based guidelines that could be used for clinical decision making to improve patient care.