The rising incidence and prevalence of diabetes along with its complications have
become a global concern. The necessity for a comprehensive model－targeting primary, secondary and tertiary prevention as well as all levels of care has become apparent. Staged Diabetes Management (SDM) was developed over a decade ago by the International Diabetes Centers, Minneapolis, Minnesota, U.S.A.. SDM was founded on the principle that a detailed understanding of the natural history of diabetes and the underlying defects responsible for the development of hyperglycemia and its associated complications should be the basis of sound clinical decision－making. It relies on clinical pathways to guide the clinicians though the detection, treatment and follow up of each type. Unique to SMD is that each pathway is customized for utilization in collaboration with local physicians and allied heath professionals. Thus far clinicians from 22 countries, using 11 translated versions of SDM, have participated in this process. In Korea, SDM was introduced in 1999 with the foundation of the committee in Korean Diabetes Association (KDA). Taking into account the regional difference in medical practice, resource allocation, availability of pharmacological agents and access to care, this Korean version of SDM was developed to reduce variation in practice, improve screening and detection, tighten glycemic control and to increase surveillance of complications. It has been noted that diabetes contributes to the cost of medical services. One way of reducing the financial burden is to find cost－effective approaches to prevention, detection and treatment of diabetes and its complications. The SDM model directly addresses this issue by seeking ways to optimize the limited resources available for diabetes care, prioritizing treatment, reducing medical error and expanding the role of allied health professionals. As SDM moves into the 21st century, its mission has expanded to encompass the principles of primary and secondary prevention.
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