From guidelines to practice: an Egyptian expert opinion on type 2 diabetes mellitus management in primary care settings

The broad classification of diabetes includes type 1 diabetes, type 2 diabetes, gestational diabetes, and other specific types such as monogenic diabetes. Additionally, prediabetes represents an at-risk state that requires early recognition. The incidence of type 2 diabetes mellitus (T2DM) has risen over the years, necessitating continuous medical care from well-trained staff. Accurate classification of diabetes is crucial for determining the appropriate treatment approach for each case. While this expert panel opinion specifically addresses management of T2DM, awareness of other categories is important to avoid misclassification and ensure timely referral. The diagnosis of diabetes hinges on the measurement of blood glucose levels, with specific thresholds defining both prediabetes and diabetes. Early diagnosis and proper diabetes treatment can prevent or delay the onset of diabetes-associated complications, whereas misdiagnosis or delayed diagnosis makes treatment decisions more challenging. Additionally, co-morbidities often require adjustments to standard management approaches. Junior and less experienced healthcare providers (HCPs) may struggle with these complexities, highlighting the need for clear guidance and structured support in clinical decision-making. A panel of 13 Egyptian experts analyzed global guidelines and challenges in managing diabetes in Egypt. Through a structured discussion, they formulated a streamlined resource for HCPs, outlining treatment strategies, comorbidity considerations, and referral guidelines to enhance the quality of care for people with diabetes. This expert opinion covers the following topics: (a) treatment options and glycemic targets, (b) insulin regimens, (c) T2DM associated with cardiovascular disease, and (d) diabetic kidney disease. This expert opinion provides a streamlined guide for HCPs, particularly those in primary care, to enhance diabetes management in Egypt. Adoption of such guideline-based recommendations is crucial to standardize care, improve glycemic outcomes, and reduce the long-term burden of complications. Implementing these recommendations may help mitigate diagnostic delays, optimize patient care, and reduce diabetes-related complications.