On 14th August, 2025, The BMJ, released a clinical guideline for type 2 diabetes (T2D) management under the expert guidance of the Institute of Medicine. An international panel was assembled, including patient partners, general practitioners, internists, endocrinologists, nephrologists, cardiologists, and methodologists. These members were selected for their diverse geography and expertise.
The clinical question was defined as “What are the benefits and harms of medications for adults with type 2 diabetes at varied risks of cardiovascular and kidney-related complications?” as quoted in the guideline release. An independent team of epidemiologists, clinical experts, and biostatisticians conducted a systematic review and network meta-analysis to assess the benefits and drawbacks of T2D medications. Two additional independent studies were performed:- prognostic models for cardiovascular and kidney outcomes and patient values and preferences regarding four candidate medications. They reviewed a variety of outcomes, mainly focusing on cardiovascular and kidney complications.
In accordance with The BMJ Rapid Recommendations, a GRADE framework was utilized to evaluate the certainty of outcomes and frame appropriate recommendations. These recommendations were based on risk stratification of patients according to their likelihood of developing a certain complication. Cardiovascular risk factors such as blood pressure, cholesterol levels, smoking, or family history of heart disease. Whereas the risk of kidney complications was calculated using an eGFR or albuminuria. Other factors such as retinopathy, neuropathy, obesity, hypertension, hyperlipidemia, etc., were considered.
The MAGICapp platform utilizes several risk prediction models and tools, allowing healthcare professionals to determine the probability of a specific outcome. These models use systematic reviews, network meta-analyses, and clinical trial data to generate predictions. Using this tool, healthcare practitioners can approach T2D using a personalized, evidence-based treatment.
