KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease

TLDR

The KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease is the first guideline of its kind. The guideline aims to provide clinicians and patients with actionable recommendations and infographics derived from a rigorous systematic review, while also proposing research priorities to address knowledge gaps. It covers comprehensive care, glycemic monitoring, lifestyle and antihyperglycemic interventions, self‑management, and optimal care models, and was developed through a systematic evidence review, appraisal, and GRADE‑based recommendations for a broad clinician audience, including policy and payment implications. Limitations of the evidence are discussed and areas for future research are presented.

Abstract

The Kidney Disease: Improving Global Outcomes (KDIGO) 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (CKD) represents the first KDIGO guideline on this subject. The scope includes topics such as comprehensive care, glycemic monitoring and targets, lifestyle and antihyperglycemic interventions, and approaches to self-management and optimal models of care. The goal of the guideline is to generate a useful resource for clinicians and patients by providing actionable recommendations with infographics based on a rigorous, formal systematic literature review. Another aim is to propose research recommendations for areas in which there are gaps in knowledge. The guideline targets a broad audience of clinicians treating diabetes and CKD while taking into account implications for policy and payment. The development of this guideline followed an explicit process of evidence review and appraisal. Treatment approaches and guideline recommendations are based on systematic reviews of relevant studies, appraisal of the quality of the evidence, and the strength of recommendations following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Limitations of the evidence are discussed and areas for future research are presented.