Despite extensive evidence related to the prevention and management of type 2 diabetes (T2D) and its complications, most people at risk for and people who have diabetes do not receive recommended guideline-based care. Clinical implementation of proven care strategies is of the utmost importance because without this, even the most impressive research findings will remain of purely academic interest. In this review, we discuss the promise and challenges of implementing effective approaches to diabetes prevention and care in the real-world setting. We describe successful implementation projects in three critical areas of diabetes care—diabetes prevention, glycemic control, and prevention of diabetes-related complications—which provide a basis for further clinical translation and an impetus to improve the prevention and control of T2D in the community. Advancing the clinical translation of evidence-based care must include recognition of and assessment of existing gaps in care, identification of barriers to the delivery of optimal care, and a locally appropriate plan to address and overcome these barriers. Care models that promote team-based approaches, rather than reliance on patient-provider interactions, will enhance the delivery of contemporary comprehensive diabetes care.

中文翻译：

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糖尿病护理的最后前沿：在现实世界实践中实施研究


尽管有大量证据与 2 型糖尿病 (T2D) 及其并发症的预防和管理相关，但大多数糖尿病风险人群和糖尿病患者并未接受推荐的基于指南的护理。经过验证的护理策略的临床实施至关重要，因为如果没有这一点，即使是最令人印象深刻的研究结果也将仍然纯粹是学术兴趣。在这篇综述中，我们讨论了在现实世界中实施有效的糖尿病预防和护理方法的前景和挑战。我们描述了糖尿病护理三个关键领域（糖尿病预防、血糖控制和糖尿病相关并发症预防）的成功实施项目，这些项目为进一步的临床转化奠定了基础，并推动了改善社区 T2D 的预防和控制。推进循证护理的临床转化必须包括认识和评估护理中现有的差距，识别提供最佳护理的障碍，以及解决和克服这些障碍的适合当地的计划。促进基于团队的方法而不是依赖患者与提供者互动的护理模式将增强当代综合糖尿病护理的提供。