ADA Publishes New Guidelines for Diabetes Care

The American Diabetes Association (ADA) has published its 2016 Standards of Medical Care in Diabetes guidelines to aid primary care providers in diagnosing and managing diabetes.

To update the guidelines, the ADA Professional Practice Committee searched an online database for new evidence and gathered feedback from the larger clinical community to revise or clarify existing recommendations.
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Each recommendation was rated based on its quality of evidence.

As a result, the Committee updated 8 areas:

  • Diagnosing diabetes: All adults aged 45 years and older regardless of weight, and anyone who is overweight or obese, should be screened for diabetes.
  • Glycemic targets: Anyone who uses continuous glucose monitoring or insulin pumps should have continued access after they turn age 65 years.
  • Hypoglycemia:  Those with hypoglycemia unawareness and/or frequent hypoglycemic episodes may find continuous glucose monitoring as a helpful supplemental tool to self-monitoring.
  • Medical management of diabetes: Address the patient’s psychological and social situation, and patients aged 65 and older should be assessed for cognitive impairment.
  • Managing the cardiovascular risk factor: Women aged 50 years and older should consider Aspirin therapy.
  • Screening and managing microvascular disease: Assess urinary albumin at least once per year in all patients with type 2 diabetes and comorbid hypertension and those with type 1 diabetes for 5 years or more.
  • Caring for diabetes in the hospital: Patients with persistent hyperglycemia should be started on insulin therapy at a threshold of 180 mg/dL or more.

“The synopsis focuses on 8 key areas that are important to primary care providers,” the committee concludes. “The recommendations highlight individualized care to manage the disease, prevent or delay complications, and improve outcomes.”

—Amanda Balbi

Reference:

Chamberlain JJ, Rhinehart AS, Shaefer Jr. CF, and Neuman A. Diagnosis and management of diabetes: Synopsis of the 2016 American diabetes association standards of medical care in diabetes. Ann Intern Med. Published online March 1, 2016. doi:10.7326/M15-3016.