9.1 Introduction

SIGN is a collaborative network of clinicians, other health care professionals, and patient organisations, funded by the Clinical Resource and Audit Group (CRAG) of the Scottish Executive Health Department. SIGN guidelines are developed by multidisciplinary groups using a standard methodology, based on a systematic review of the evidence. Further details about SIGN and the guideline development methodology are contained in SIGN 50: A guideline developer's handbook.

9.2 The guideline development groups

The guideline was developed by seven multidisciplinary developed groups coordinated by a steering group comprising the leaders of each of the groups, chaired by Professor Ian Campbell, Consultant Physician, Victoria Hospital, Kirkcaldy. Declerations of interest were made by all members of the guideline development groups. Guideline development and literature review expertise, support, and facilitation were provided by the SIGN Executive, in particular: Miss Francesca Chappell, Information Officer; Mr Robin Harbour, Information Manager; Dr Moray Nairn, Programme Manager; and Mr Alex Haig, formerly Information Officer, Royal College of Physicians of Edinburgh.

9.3 Systematic literature review

The evidence base for this guideline was synthesised in accordance with SIGN methodology. A systematic review of the literature was carried out using an explicit search strategy devised by the SIGN Information Team. All searches covered systematic reviews, meta-analyses, and randomised controlled trials. Where appropriate, searches were extended to cover observational studies. Due to the wide subject coverage of these guidelines, a large number of topic specific searches were required. All searches covered the Cochrane Library, Embase, Healthstar, and Medline. In appropriate cases searches were extended to cover CINAHL and Psychinfo. All searches covered the period 1991-2000. Searches for the section on children were extended back to 1980. Internet searches were carried out on the Web sites of the Canadian Practice Guidelines Infobase, the New Zealand Guidelines Programme, and US National Guidelines Clearinghouse. Searches were also carried out on the search engines Northern Light and OMNI, and all suitable links followed up.

The Medline version of the main search strategies and notes on the coverage of ancillary searches can be found on the SIGN Website, in the section covering supplementary guideline material. The main searches were supplemented by material identified by individual members of the development group. All selected papers were evaluated using standard methodological checklists before conclusions were considered as evidence.

9.4 Consultation and peer review

A national open meeting is the main consultative phase of SIGN guideline development, at which the guideline development group presents their draft recommendations for the first time. The national open meeting for this guideline was held at the Royal College of Physicians of Edinburgh on 11 December 2000. The draft guideline was also available on the SIGN website for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline.

The guideline was reviewed in draft form by a panel of independent expert referees, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence base supporting the recommendations in the guideline. SIGN is very grateful to all of these experts for their contribution to this guideline. The specialist reviewers and Editorial Group for this guideline are listed on the SIGN website at www.sign.ac.uk.

Children and young people with diabetes

Dr Stephen Greene, Consultant paediatrician, Ninewells Hospital, Dundee (Chairman)
Dr Kenneth Robertson, Consultant Paediatrician, Royal Hospital for Sick Children, Glasgow (Methodologist)
Dr Ian Craigie, Staff Grade Paediatrician, Royal Hospital for Sick Children, Glasgow (Secretary)
Sister Ann Brooker, Diabetes Nurse Specialist, Royal Hospital for Sick Children
Dr Linda de Caestaeker, Consultant in Public Health, Greater Glasgow Health Board
Mr Gregory Colgan, young peron with diabetes, Dundee
Ms Mary Deans, Paediatric Dietitian, Royal Hospital for Sick Children, Edinburgh
Dr Chris Kelnar, Consultant Paediatrician, Royal Hospital for Sick Children, Edinburgh
Dr Clare McCormick, General Practitioner, Beith
Dr Kathryn Noyes, Staff Grade Paediatrician, Royal Hospital for Sick Children, Edinburgh
Ms Harmony Richardson, Diabetes Nurse Specialist, Edinburgh
Dr Cameron Shepherd, Consultant Paediatrician, Inverclyde Royal Hospital, Greenock
Ms Christine Skivington, Diabetes Nurse Specialist, Gartnaval General Hospital, Glasgow
Mrs Honor Shaw, Parent, Cumbernauld
Dr Peter Smail, Consultant Paediatrician, Aberdeen Royal Infirmary
Dr Michael Small, Consultant Diabetologist, Gartnavel General Hospital, Glasgow
Dr Ion Wyness, Clinical Psychologist, St John's Hospital, Livingston

Lifestyle management

Dr Ann Gold, Consultant Physician, Aberdeen Royal Infirmary (Chairman)
Dr John McKnight, Consultant Diabetologist, Western General Hospital, Edinburgh (Methodologist)
Dr Mary Joan McLeod, Lecturer in Clinical Pharmacology, Aberdeen University (Secretary)
Ms Jacqui Charlton, Diabetes Nurse Specialist, Western General Hospital, Edinburgh
Miss Yvonne Doherty, Clinical Psychologist, North Tyneside General Hospital, North Sheilds
Mrs Jennifer Donaldson, Practice Nurse, Aberfeldy
Mrs Lesley Grant, Dietician, Ninewells Hospital, Dundee
Dr Alex Greene, Social Anthropologist, University of St Andrews
Dr Cathy Higginson, Research Specialist, Health Education Board for Scotland
Dr Ken Lyons, General Practitioner, Renfreww Health Centre, Paisley
Mr Bill Marshall, Patient Representative, Glasgow
Dr Stan Murray, Consultant in Public Health, Greater Glasgow Health Board
Dr Nanette Mutrie, Senior Lecturer in Sport & Exercise Science & Medical Education, University of Glasgow
Dr David Wright, General Practitoner, Aberfeldy

Cardiovascular disease

Dr Andrew Harrower, Consultant Physician, Monklands Hospital, Airdrie (Chairman)
Dr Andrew Morris, Consultant Physician, Ninewells Hospital, Dundee (Methodologist)
Dr John Petrie, Senior Lecturer, University of Glasgow (Secretary)
Mr Bill Barr, Patient Representative, Glasgow
Dr Geraldine Brennan, Consultant Physician, Stracathro Hospital
Ms Margaret Cavanagh, Practice Nurse, Burnbank Medical Centre, Hamilton
Dr Martin Cowie, Consultant Cardiologist, Aberdeen Royal Infirmary
Dr David Cromie, Consultant in Public Health Medicine, Lanarkchire Health Board
Dr Marion Devers, Specialist Registrat in Diabetes and Endocrinology, Wetsrn Infirmary, Glasgow
Dr Miles Fisher, Consultant Physician, Royal Alexandria Hospital, Paisley
Dr Jane Hunter, General Practitioner, Leven Health Centre, Fife
Dr David Northridge, Consultant Cardiologist, Western General Hospital, Edinburgh
Ms Marjory Thompson, Roodlands Hospital, Haddington
Mrs Janice Tinlin, Diabetes Nurse Specialist, Queen Margaret Hospital, Dunfermline
Dr Sandy Young, General Practitioner, Alyth

Renal disease

Dr James Walker, Consultant Physician, Royal Infirmary of Edinburgh (Chairman)
Dr Izhar Khan, Consultant Nephrologist, Aberdeen Royal Infirmary (Methodologist)
Dr Mark Strachan, Specialist Regitrat in Diabetes, Western General Hospital, Edinburgh (Secretary)
Dr Leslie Bisset, General Practitioner, Leven Health centre, Fife
Dr Michael Boulton-Jones, Consultant Physician, Glasgow Royal Infirmary
Dr Ian Dickson, General Practitioner, Edinburgh
Dr Tim Dyke, Consultant in Public Health, Fife Health Board
Dr David Jenkins, Consultant Nephrologist, Queen Margaret Hospital, Dunfermline
Dr Sandra MacRury, Consultant Diabetologist, Raigmore Hospital, Inverness
Miss Mary Scott, Lothian Diabetes Facilitator, Western General Hospital, Edinburgh
Mrs Elizabeth Sloan, Renal Dietician, Royal Infirmary of Edinburgh

Visual impairment

Dr Graham Leese, Consultant Physician, Ninewells Hospital, Dundee (Chairman)
Dr Margaret MacDonald, Consultant Opthalmologist, Queen Margaret Hospital, Dunfermline (Methodologist)
Dr Satindar Bal, Specialist Registrar, Glasgow Royal Infirmary (Secretary)
Ms Joan Alwinkle, Diabetes Nurse Specialist, Royal Infirmary of Edinburgh
Dr John Ellis, Research Fellow, Ninewells Hospital, Dundee
Dr Alastair Emslie-Smith, General Practitioner, Dundee
Professor John Forrester, Consultant Opthalmologist, Aberdeen Royal Infirmary
Dr Jim Hutton, General Practitioner, Alness
Dr John Olson, Consultant in Medical Opthalmology, Aberdeen Royal Infirmary
Mr David Paul, Patient Representative, Glasgow
Mr Ian Wallace, Optometrist, Oban

Foot disease

Dr Sheila Reith, Consultant Physician, Stirling Royal Infirmary (Chairman)
Dr Steven Cleland, Career Registrar in Diabetes, Western infirmary, Glasgow (Secretary)
Dr David Cunningham, General Practitioner, Irvine Group
Mr Gareth Griffiths, Vascular Surgeon, Ninewells Hospital, Dundee
Mr Les Hogarth, Podiatrist, Victoria Hospital, Kirkcaldy
Mr Amar Singh Jain, Orthopaedic Surgeon, Ninewells Hospital, Dundee
Mr Ken Moyes, Orthotist, Ninewells Hospital, Dundee
Mr Neil Orr, Patient Representative, Strathaven
Dr Simon Willetts, General practitioner, Jersey
Dr Matthew Young, Consultant Diabetologist, Royal Infirmary, Edinburgh

Diabetes in Pregnancy

Dr Donald Pearson, Consultant Physician, Aberdeen Royal infirmary (Chairman)
Dr Gillian Penney, National Co-ordinator, Scottish Programme for Clinical Effectiveness in Reproductive Health (Methodologist)
Dr Fiona Strachan, Specialist regisrar in Diabetes and Endocrinology, Aberdeen Royal Infirmary (Secretary)
Dr Frank Johnstone, Consultant Obstetrician, Edinburgh Royal Infirmary
Miss Patricia Kelly, Specialist Midwife, Royal Maternity Hospital, Glasgow
Dr David Lloyd, Consultant Neonateologist, Aberdeen Royal Infirmary
Dr Burnett Lunan, Clinical Director-Gynaecology and Pre-natal Medicine, Glasgow Royal Infirmary
Dr David Matthews, Consultant Physician, Monklands Hospital, Lanarkshire
Sister Trish McCue, Diabetes Nurse Specialist, Monklands Hospital, Lanarkshire
Dr Christine Roxburgh, General Practitoner, Perth
Ms Pam Smith, Patient Representative
Dr Judith Steel, Associate Specialist, Victoria Hospital, Kirkcaldy
Mrs Morag Thomson, Senior Dietician in Diabetes, Southern general Hospital, Glasgow

The following individuals also contributed to the guideline:

Miss Florence Brown, Diabetes Nurse Specialist, Gartnavel General Hospital, Glasgow
Dr Ewen Harley, General Practitoner, Glasgow
Mr Bob Hunter, Patient Representative, Edinburgh
Mr Bill Maddox, Patient Representative, Dundee
Ms Carine Nelson, Practice Nurse, Bothwell, Glasgow
Dr Jill Pell, Consultant in Public health, Greater Glasgow Health Board
Dr Norman Waugh, Senior Lecturer, Institute of Health Research and Development, Southampton