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ADA Releases New Standards of Medical Care In Diabetes


December 16, 2016

The American Diabetes Association have recommended improvements to psychological health treatment, new cardiovascular treatment options, personalized treatment options, and more in their annual standard update.

The ADA’s 2017 “Standards of Medical Care in Diabetes” is part of an annual update that focuses on improving care for patients with type 1 and type 2 diabetes based on the latest evidence-based research.

“This year, the standards include critical, new evidence-based additions—psychosocial care, expanded physical fitness, metabolic surgery, and hypoglycemia—all of which can impact effective diabetes care,” Robert E Ratner, MD, chief scientific and medical officer for ADA, said in a press release. “Together, the new standards and the differentiation report will guide health care providers and patients around the world in a multi-disciplinary approach to provide a comprehensive, individualized diabetes care plan—a plan that accounts for the whole patient and the many variables that can impact their ability to successfully manage diabetes, and thus leads to improved health outcomes.”

The new standards include a recommendation to consider use of liraglutide and empagliflozin among patients at high risk for cardiovascular disease. These glucose-lowering drugs have recently been found to lower the risk of death.

The guidelines also include new measures to ensure the mental health of diabetes patients, including screening adults and children with diabetes for diabetes distress, depression, anxiety and eating disorders. According to the press release, these recommendations were made “due to the greater risk of psychological/emotional stress and disorders in people with diabetes…”

Lifestyle management guideline changes were also made to include the recommendation of physical activity every 30minutes to interrupt sedentary behavior. The standards also include screening for sleep disorders that can affect blood glucose management.

Other recommendations included a list of comorbidities that should be considered for personalized diabetes treatment, such as HIV, anxiety disorders, depression, and eating disorders. Bariatric surgery was also added as a treatment option for patients with inadequately controlled type 2 diabetes.

Additional recommendations included hospital management improvements, maternal and pregnancy care, new first-line hypertension treatment options, and updated hypoglycemia indication levels.

David Costill

Reference:

American Diabetes Association. Standards of Medical Care in Diabetes—2017: Summary of Revisions. Diabetes Care 2017 Jan; 40(Supplement 1): S4-S5. https://doi.org/10.2337/dc17-S003

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