Growth performance, nutrient digestibility and serum biochemical indices of finisher broiler chickens fed varying levels of sorghum in replacement of maize with the supplementation of exogenous enzymes

A 28 days feeding trial was conducted with a total of one hundred and eighty broiler chickens to evaluate the effect of maize-sorghum based diets supplemented with exogenous enzyme on growth performance, nutrient digestibility and serum biochemical indices of finisher broiler chickens. Six experimental diets were formulated in which maize based diet served as Control (T1). Maize in the control diet was replaced by sorghum at the levels of 20% (T2), 40% (T3), 60% (T4), 80% (T5), and 100% (T6), respectively with 50g/100kg enzyme supplementation. The broiler chicks were allotted to six dietary treatments of 30 birds replicated three times with 10 birds per replicate. Dietary Treatments showed significant (P<0.05) effect on final weight and total feed intake. Similar higher statistical values of 1814.67g and 1804.67g were recorded for final weight in birds fed 80% sorghum (T5) and 100% sorghum (T6). Dietary Treatments had significant (p < 0.05) influence on Total protein and cholesterol. Varying levels of sorghum showed (p<0.05) effect on dry matter, crude protein and crude fiber digestibility. In conclusion, feeding finisher broiler chickens up to 100% sorghum replacement level for maize with enzyme supplementation improved growth performance and efficient nutrient digestibility without deleterious effect on the birds. Keywords: Maize-sorghum; Enzyme; Performance; Serum biochemistry; Nutrient digestibility; Broilers

Primary stroke prevention worldwide : translating evidence into action

Funding Information: The stroke services survey reported in this publication was partly supported by World Stroke Organization and Auckland University of Technology. VLF was partly supported by the grants received from the Health Research Council of New Zealand. MOO was supported by the US National Institutes of Health (SIREN U54 HG007479) under the H3Africa initiative and SIBS Genomics (R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, and 1R01NS114045-01), Sub-Saharan Africa Conference on Stroke Conference (1R13NS115395-01A1), and Training Africans to Lead and Execute Neurological Trials & Studies (D43TW012030). AGT was supported by the Australian National Health and Medical Research Council. SLG was supported by a National Heart Foundation of Australia Future Leader Fellowship and an Australian National Health and Medical Research Council synergy grant. We thank Anita Arsovska (University Clinic of Neurology, Skopje, North Macedonia), Manoj Bohara (HAMS Hospital, Kathmandu, Nepal), Denis ?erimagi? (Poliklinika Glavi?, Dubrovnik, Croatia), Manuel Correia (Hospital de Santo Ant?nio, Porto, Portugal), Daissy Liliana Mora Cuervo (Hospital Moinhos de Vento, Porto Alegre, Brazil), Anna Cz?onkowska (Institute of Psychiatry and Neurology, Warsaw, Poland), Gloria Ekeng (Stroke Care International, Dartford, UK), Jo?o Sargento-Freitas (Centro Hospitalar e Universit?rio de Coimbra, Coimbra, Portugal), Yuriy Flomin (MC Universal Clinic Oberig, Kyiv, Ukraine), Mehari Gebreyohanns (UT Southwestern Medical Centre, Dallas, TX, USA), Ivete Pillo Gon?alves (Hospital S?o Jos? do Avai, Itaperuna, Brazil), Claiborne Johnston (Dell Medical School, University of Texas, Austin, TX, USA), Kristaps Jurj?ns (P Stradins Clinical University Hospital, Riga, Latvia), Rizwan Kalani (University of Washington, Seattle, WA, USA), Grzegorz Kozera (Medical University of Gda?sk, Gda?sk, Poland), Kursad Kutluk (Dokuz Eylul University, ?zmir, Turkey), Branko Malojcic (University Hospital Centre Zagreb, Zagreb, Croatia), Micha? Maluchnik (Ministry of Health, Warsaw, Poland), Evija Migl?ne (P Stradins Clinical University Hospital, Riga, Latvia), Cassandra Ocampo (University of Botswana, Princess Marina Hospital, Botswana), Louise Shaw (Royal United Hospitals Bath NHS Foundation Trust, Bath, UK), Lekhjung Thapa (Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Kathmandu, Nepal), Bogdan Wojtyniak (National Institute of Public Health, Warsaw, Poland), Jie Yang (First Affiliated Hospital of Chengdu Medical College, Chengdu, China), and Tomasz Zdrojewski (Medical University of Gda?sk, Gda?sk, Poland) for their comments on early draft of the manuscript. The views expressed in this article are solely the responsibility of the authors and they do not necessarily reflect the views, decisions, or policies of the institution with which they are affiliated. We thank WSO for funding. The funder had no role in the design, data collection, analysis and interpretation of the study results, writing of the report, or the decision to submit the study results for publication. Funding Information: The stroke services survey reported in this publication was partly supported by World Stroke Organization and Auckland University of Technology. VLF was partly supported by the grants received from the Health Research Council of New Zealand. MOO was supported by the US National Institutes of Health (SIREN U54 HG007479) under the H3Africa initiative and SIBS Genomics (R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, and 1R01NS114045-01), Sub-Saharan Africa Conference on Stroke Conference (1R13NS115395-01A1), and Training Africans to Lead and Execute Neurological Trials & Studies (D43TW012030). AGT was supported by the Australian National Health and Medical Research Council. SLG was supported by a National Heart Foundation of Australia Future Leader Fellowship and an Australian National Health and Medical Research Council synergy grant. We thank Anita Arsovska (University Clinic of Neurology, Skopje, North Macedonia), Manoj Bohara (HAMS Hospital, Kathmandu, Nepal), Denis Čerimagić (Poliklinika Glavić, Dubrovnik, Croatia), Manuel Correia (Hospital de Santo António, Porto, Portugal), Daissy Liliana Mora Cuervo (Hospital Moinhos de Vento, Porto Alegre, Brazil), Anna Członkowska (Institute of Psychiatry and Neurology, Warsaw, Poland), Gloria Ekeng (Stroke Care International, Dartford, UK), João Sargento-Freitas (Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal), Yuriy Flomin (MC Universal Clinic Oberig, Kyiv, Ukraine), Mehari Gebreyohanns (UT Southwestern Medical Centre, Dallas, TX, USA), Ivete Pillo Gonçalves (Hospital São José do Avai, Itaperuna, Brazil), Claiborne Johnston (Dell Medical School, University of Texas, Austin, TX, USA), Kristaps Jurjāns (P Stradins Clinical University Hospital, Riga, Latvia), Rizwan Kalani (University of Washington, Seattle, WA, USA), Grzegorz Kozera (Medical University of Gdańsk, Gdańsk, Poland), Kursad Kutluk (Dokuz Eylul University, İzmir, Turkey), Branko Malojcic (University Hospital Centre Zagreb, Zagreb, Croatia), Michał Maluchnik (Ministry of Health, Warsaw, Poland), Evija Miglāne (P Stradins Clinical University Hospital, Riga, Latvia), Cassandra Ocampo (University of Botswana, Princess Marina Hospital, Botswana), Louise Shaw (Royal United Hospitals Bath NHS Foundation Trust, Bath, UK), Lekhjung Thapa (Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Kathmandu, Nepal), Bogdan Wojtyniak (National Institute of Public Health, Warsaw, Poland), Jie Yang (First Affiliated Hospital of Chengdu Medical College, Chengdu, China), and Tomasz Zdrojewski (Medical University of Gdańsk, Gdańsk, Poland) for their comments on early draft of the manuscript. The views expressed in this article are solely the responsibility of the authors and they do not necessarily reflect the views, decisions, or policies of the institution with which they are affiliated. We thank WSO for funding. The funder had no role in the design, data collection, analysis and interpretation of the study results, writing of the report, or the decision to submit the study results for publication. Funding Information: VLF declares that the PreventS web app and Stroke Riskometer app are owned and copyrighted by Auckland University of Technology; has received grants from the Brain Research New Zealand Centre of Research Excellence (16/STH/36), Australian National Health and Medical Research Council (NHMRC; APP1182071), and World Stroke Organization (WSO); is an executive committee member of WSO, honorary medical director of Stroke Central New Zealand, and CEO of New Zealand Stroke Education charitable Trust. AGT declares funding from NHMRC (GNT1042600, GNT1122455, GNT1171966, GNT1143155, and GNT1182017), Stroke Foundation Australia (SG1807), and Heart Foundation Australia (VG102282); and board membership of the Stroke Foundation (Australia). SLG is funded by the National Health Foundation of Australia (Future Leader Fellowship 102061) and NHMRC (GNT1182071, GNT1143155, and GNT1128373). RM is supported by the Implementation Research Network in Stroke Care Quality of the European Cooperation in Science and Technology (project CA18118) and by the IRIS-TEPUS project from the inter-excellence inter-cost programme of the Ministry of Education, Youth and Sports of the Czech Republic (project LTC20051). BN declares receiving fees for data management committee work for SOCRATES and THALES trials for AstraZeneca and fees for data management committee work for NAVIGATE-ESUS trial from Bayer. All other authors declare no competing interests. Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseStroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.publishersversionPeer reviewe

Effect of dietary copper and probiotic supplementation on growth performance and carcass characteristics of broiler chickens

This study was conducted to investigate the effect of dietary copper and probiotic supplementation on growth performance and carcass  characteristics of broiler Chickens. A total of 180-day old marshal broiler chicks of mixed sex were randomly allotted to six treatment groups of 30 birds each. The Treatments were divided into three replicates of ten birds each; starter and finisher diets were formulated and fed for a period of  fifty-six days. The dietary treatments were subjected to completely randomized design experimental layout which was made up of probiotic (0 and 500ppm) and copper (0, 125 and 250mg).The chicks were fed the broiler starter diet for the first 28 days and broiler finisher for the last 28 days. Treatment effect on broiler body weight, feed intake and feed conversion ratio were determined on a weekly basis. Data obtained were analyzed  using analysis of variance (ANOVA) and, Duncan's Multiple Range Test was used to separate significant means. Dietary supplementation of copper and probiotic had no significant (P > 0.05) effect on final weight (FW), daily weight gain (DWG), feed intake (FI), and feed conversion ratio (FCR) at the starter phase of the experiment. However, at finisher phase, inclusion of probiotic resulted in higher significant (P < 0.05) values for FW  (2214.12g/b) DWG (60.22g/b/d), FI (159.02g/b/d), and FCR (2.64). The carcass yields of the broilers were significantly (P< 0.05) influenced by copper and probiotic supplementations. However, lower value (1.07%) was obtained for abdominal fat in broilers fed 250mg Cu/kg supplemented diet. The study concluded that supplementation of copper and probiotics resulted in improved growth performance and carcass yield of broiler chickens. Keywords: Dietary Copper; probiotic supplementation; broiler chicks

Performance and carcass characteristics of broiler chickens fed maize-cassava diets supplemented with methionine and inorganic sulphur

The major challenges of cassava supplementation in poultry diets are high cyanide and low protein content. This study was conducted to evaluate the nutritional value of maize-cassava diets supplemented with methionine and inorganic sulphur for broiler chickens. A total of 270 one day-old broiler chicks were randomly assigned to nine treatment groups of 30 birds with 10 birds per replicate. Starter and finisher diets were formulated  and fed for a period of 56 days. Dietary treatments were subjected to completely randomized design. The birds were fed diets supplemented with 0, 125, 250 mg/kg DL-methionine and 0, 125, 250 mg/kg inorganic sulphur from CuSO .There was a linear increase in final weight (FW) and total weight  gain 4 (TWG) w th supplementation of 125mg/kg DL-methionine across dietary sulphur levels at the starter phase. Birds fed diets  supplemented with 125 mg/kg DL-methionine and 250 mg/kg inorganic sulphur showed higher (p<0.05values of 463.23g, 424.66g and 2.66 for FW, TWG and feed conversion ratio respectively. The finisher phase followed a similar trend. Carcass yield showed significant (p<0.05) improvement in dress weight, cut part and organ weight in birds fed diets supplemented with 125 mg/kg DL-methionine and 250 mg/kg inorganic sulphur. The findings revealed that birds with diets supplemented with125 mg/kg DL-methionine and 250 mg/kg inorganic sulphur showed improved growth performance and carcass yield. In conclusion from this study supplementation of DL-methionine and inorganic sulphur in diets for broiler chickens resulted in improved growth performance and carcass yield. Keywords: Maize-cassava, DL-Methionine, inorganic sulphur, broiler chicke

Haematological and biochemical responses of starter broiler chickens fed copper and probiotic supplemented diets

A study was conducted to investigate the haematological and biochemical responses of starter broiler chickens fed copper and probiotics supplemented diets. A total of 180-day old Marshal broiler chicks were randomly allotted to six treatment groups of 30 birds each. The treatments were divided into three replicates of ten birds each; starter diet was formulated and fed for a period of twenty-eight days. The dietary treatments were subjected to complete randomized design arranged in a 2×3 factorial arrangement was made up of probiotics (0 and 500ppm) and copper (0, 125 and 250mg). Data were collected on haematological and serum biochemical indices. Data obtained were analysed using analysis of variance (ANOVA) and, Duncan’s Multiple Range Test was used to separate significant means. Dietary supplementation of copper and probiotics showed significant influence (P < 0.05) on haematological and biochemical indices. Biochemical analyses revealed higher significant (P < 0.05) copper × probiotics interaction values of 42.81 g/l, 19.50 g/l and 23.31 g/l for total protein, albumin and globulin respectively in the birds fed 250 mg/kg copper × 500 ppm probiotics /kg. Birds fed control diet recorded lower significant (P < 0.05) values of 33.85 g/l and 15.40 g/l for total protein and albumin. In contrast, birds fed diet supplemented with 250 mg/kg copper × 500 ppm probiotics /kg recorded least significant (P < 0.05) copper x probiotics interaction values of 149.20 mg/dl, 49.00 mg/dl, 46.48 mg/dl and 81.56 mg/dl for cholesterol, triglyceride, high density lipoprotein and low density lipoprotein respectively. Birds on control diet recorded highest values for cholesterol, triglyceride, high-density lipoprotein and low density lipoprotein (respectively). Dietary copper and probiotics supplementation influenced haematological parameters. Copper x probiotics interaction significantly (P < 0.05) influenced white blood cell, glucose, lymphocyte and eosinophil. Broilers fed diet containing 250 mg/kg copper x 500 ppm probiotics /kg had significantly higher white blood cell (30.65x109/L) than the birds on control diet (26.15 ×109/L). No significant (P > 0.05) copper × probiotic interaction influence on packed cell volume, haemoglobin, red blood cell, neutrophil and monocyte. It can be concluded that dietary copper and probiotics supplementation had significant interaction influence on birds at 250 mg/kg copper × 500 ppm probiotics /kg supplemental level. It could be inferred that the supplementation of both copper and probiotics to starter broiler diet significantly improved the immune-competence of the broiler starters.Key words: haematological; biochemical; copper; probiotics; broiler chicken

Haematology and serum chemistry of finisher broiler chickens fed maize-cassava diet supplemented with methionine and inorganic sulphur

This study was conducted to assess the haematology and serum chemistry of broiler chickens fed maize-cassava diets supplemented with methionine and inorganic sulphur. A total of 270 day-old broiler chicks were randomly assigned to nine treatment groups of 30 birds making 10 birds per replicate group. Starter and finisher diets were formulated and fed for a period of 56 days. Dietary treatments were subjected to Completely Randomized Design in a 3 × 3 factorial experimental layout. Birds were fed diets supplemented with 0, 125, 250 mg/kg DL-methionine and 0, 125, 250 mg/kg inorganic sulphur from CuSO4. Results of haematological parameters showed no significant (p>0.05) difference among the treatment groups except the packed cell volume. The higher value of 31.33% was obtained for PCV in the birds fed diet supplemented with 0mg/kg DL-methionine + 125mg/kg CuSO4. Values recorded for biochemical indices varied significantly (p<0.05) among dietary treatments for total protein, globulin and cholesterol. High significant (p<0.05) values of 50.80 g/l and 29.85 g/l were obtained for total protein and globulin in the birds fed diet supplemented with 125 mg/kg DL-methionine + 250 mg/kg CuSO4. Lower (p<0.05) value of 155.81mg/dl was recorded for cholesterol in birds fed diet supplemented with 250 mg/kg DL-methionine + 250 mg/kg inorganic sulphur. Based on the results obtained for haematological and serum chemistry parameters, it was concluded that supplementation of DL-methionine and inorganic sulphur in broiler diet at 125 mg/kg DL-methionine + 250 mg/kg inorganic sulphur level of supplementation improved dietary protein and had no inimical effect.Key words: Maize-cassava; DL-methionine; inorganic sulphur; haematology; serumchemistry

Evaluation of maize-yam peel meal based diets supplemented with exogenous cocktail enzymes on growth performance, nutrient digestibility and metabolisable energy in finisher broiler chickens.

This study was conducted to investigate the effect of maize and yam peels meal based diets with and without enzyme supplementation on the growth performance and nutrient digestibility of broiler chickens at finisher phase. One hundred and eighty (180), one day-old broiler chicks were fed six diets in two groups. The experiment was arranged in a 2 × 3 factorial experimental layout of two levels of enzyme (0g/100kg diet and 50g/100kg diet) and three levels of yam peels inclusion (0kg, 15kg and 30kg). Each treatment was replicated 3 times consisting of 10 chicks per replicate. The experiment lasted 4 weeks. Main effect of graded levels of yam peel meal and enzymes supplementation on growth performance of starter broiler chickens showed significant (P ? 0.05) influence on final weight, total weight, total weight grain and daily weight grain. Birds fed 0% YPM recorded higher statistical value of 2549.00g for final weight. Interaction effect of YPM and enzyme showed significant (<0.05) effect on growth performance of finisher broiler chickens. Final weight, total weight gain and daily weight gain were significantly (<0.05) influenced by interaction of YPM and enzyme. Birds fed control diet (T ) recorded higher significant (P<0.05) values for final 1 weight of comparative level. Least value of 2220.00g was recorded for final weight in the birds fed 15% YPM without enzyme (T ). Varying levels of YPM as a partial replacement for 2 maize had no significant (P>0.05) effect on nutrient digestibility. Higher values were recorded for birds fed 0% inclusion level of YPM across the parameter determined with the exception of ether extract and ash. Inclusion of YPM with enzyme supplementation had significant (P<0.05) interaction effects on percentage dry matter digestibility, crude protein digestibility and crude fibre digestibility. Dry matter digestibility decreased with increased level of YPM with or without enzyme. Inclusion of yam peels meal up to 30% level of replacement for maize with or without enzyme supplementation could be recommended for appreciable nutrient digestibility and improved growth performance of finisher broiler chickens

Performance and Economic of Production of Broiler Chickens fed Maize and Yam Peels based Diets supplemented with Xylanase, Amylase and Protease Multi-enzymes at starter phase Target audience: Nutritionist, researchers, feed millers and poultry farmers

This study was conducted to investigate the effect of maize and yam peels meal based diets with and without enzyme supplementation on the growth performance and economic of production of broiler chickens at starter phase. One hundred and eighty (180) day old broiler chicks were fed six diets in two groups. The first group of diets contained: maize replaced with yam- peel (YPM) at 0%, 15% and 30 % levels without enzyme supplementation designated as T1, T2 T3 respectively. The second group of diets contained maize replaced with YPM at 0%, 15% and 30% with enzyme supplementation of 50g/kg designated as T4, T5 T6 respectively. Birds were allotted to 6 dietary treatments in a completely randomized design. Each treatment was replicated 3 times consisting of10 chicks per replicate. The experiment lasted for 4 weeks. The results of growth performance showed significant differences (P<0.05) in final weight, weight gain, daily weight gain and feed intake. . Higher l values were recorded for birds fed T1 (control diet) and T6 (diet containing 30% yam peel meal with enzyme supplementation) across the treatments. . Birds fed control diet (T1) and diet containing 30% yam peel meal with enzyme (T6) had higher values of 909.93g and 903.21g respectively for final weight at comparative level to others. However, lower significant (P < 0.05) values were obtained for birds fed T4 (diet containing 0% yam peel meal with enzyme) and T5 (diet containing 15% yam peel meal with enzyme supplementation) across the parameters measured. No significant differences (P > 0.05) in feed conversion ratio. However, operation cost and cost of DOC interaction of yam peel meal and enzyme showed significant difference (P < 0.05) in determining for economic production. The economic analysis revealed that cost in N/kg of diet decreased linearly with increased of level of yam peel meal with and without enzyme supplementation in the diet. Birds fed control diet (T1) and diet contained 0g yam peel meal with enzyme (T4) had higher values for cost of feed consumed per bird, cost of production, feed cost percentage and total cost. The profit margin ranged from N154.80 - N 178.40 for birds fed diet contained 30% yam peel meal with enzyme (T6) having the highest gross margin. Based on the results of this study, it was concluded that yam peel meal can replace maize up to 30% in broiler starter ration with or without enzyme for improved performance with some reduction in the cost of production. .. From economic point of view in term of profit margin, 30% yam peel meal with enzyme supplementation is recommended.Key words: Yam peel meal, enzyme, performance, economic production, broiler chick

Effect of Maize and Yam peels based Diets Supplemented with Xylanase, Amylase and Protease Multi-Enzymes on Serum Biochemical and Haematological Indices of Starter Broiler Chickens

A study was conducted using one hundred and eighty (180) day old broiler chicks to determine the effect of maize and yam peels meal based diets supplemented with and without enzymes on the haematological and serum biochemical indices of broiler chickens at starter phase. Birds were allotted to six dietary treatments in a completely randomized design CRD in factorial arrangement. Two levels of enzyme (0g/kg diet and 50g/kg diet) and three levels of yam peels inclusion (0%, 15 % and 30 %) as a replacement for maize. Each treatment was replicated 3 times consisting of 10 chicks per replicate. The experiment lasted for 4 weeks. The results of serum biochemical indices revealed that Yam peels meal (YPM) inclusion and enzyme supplementation had no significant (P > 0.05) effect on all the parameters determined. The interaction effect of YPM inclusion and enzyme supplementation on serum biochemical indices showed significant differences (P< 0.05) on total protein, globulin, glucose and creatinine. Higher statistical values of total protein (3.70 g/dl and 3.85 g/dl) were obtained for birds fed 15% YPM treatment without enzyme (T2) and birds fed 0% YPM diet with enzyme supplementation (T4) respectively. The control diet significantly showed least (P < 0.05) value of total protein (2.85 g/dl). Birds fed 15% YPM diet without enzyme (T2) and 0% YPM with enzyme (T4) showed higher numerical values of 204.00 mg/dl and 203.53 mg/dl for glucose at comparative level. The result of haematological indices revealed that there significant differences (P < 0.05) in interaction for all the parameters obtained with level of YPM inclusion and enzyme supplementation. Birds fed 15% YPM diet without enzyme (T2) and 0% YPM with enzyme (T4) showed higher statistical values of 39.50% and 38.00% for PCV. Similar trend was observed for Haemoglobin, white blood cell, Red blood cell and Mean corpuscular haemoglobin. Close range values which suggested good health status were obtained for both serum biochemical and haematological indices across the treatments. In conclusion, interaction of yam peels meal with or without enzyme supplementation had significant improvement on starter broiler chickens and values recorded for haematological parameters were within the normal range for broiler chickens without adverse effect on health condition of the birds.Key words: Yampeel meal; enzymes; haematological indices; serum biochemistry; broiler chickens

Gaps in guidelines for the management of diabetes in low- and middle-income versus high-income countriesda systematic review

OBJECTIVE: The extentto which diabetes (DM) practice guidelines, often basedon evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND METHODS: Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences. RESULTS: Most LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination planaswellassocioeconomic and ethical-legal contextualization.LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines (P < 0.001). CONCLUSIONS: A new approachto the contextualization, content development, and deliveryofLMIC guidelines is needed to improve outcomes. © 2018 by the American Diabetes Association