Classification, Pathophysiology, Diagnosis And Management Of Diabetes Mellitus
University of Gondar, Ethopia *Corresponding Author: Habtamu Wondifraw Baynes Lecturer Clinical Chemistry University of Gondar, Gondar Amhara 196, Ethiopia Tel: +251910818289 E-mail: [email protected] Citation: Baynes HW (2015) Classification, Pathophysiology, Diagnosis and Management of Diabetes Mellitus. J Diabetes Metab 6:541. doi:10.4172/2155-6156.1000541 Copyright: © 2015 Baynes HW. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes Mellitus (DM) is a metabolic disorder characterized by the presence of chronic hyperglycemia either immune-mediated (Type 1 diabetes), insulin resistance (Type 2), gestational or others (environment, genetic defects, infections, and certain drugs). According to International Diabetes Federation Report of 2011 an estimated 366 million people had DM, by 2030 this number is estimated to almost around 552 million. There are different approaches to diagnose diabetes among individuals, The 1997 ADA recommendations for diagnosis of DM focus on fasting Plasma Glucose (FPG), while WHO focuses on Oral Glucose Tolerance Test (OGTT). This is importance for regular follow-up of diabetic patients with the health care provider is of great significance in averting any long term complications. Keywords Diabetes mellitus; Epidemiology; Diagnosis; Glycemic management Abbreviations DM: Diabetes Mellitus; FPG: Fasting Plasma Glucose; GAD: Glutamic Acid Decarboxylase; GDM: Gestational Diabetes Mellitus; HDL-cholesterol: High Density Lipoprotein cholesterol; HLA: Human Leucoid Antigen; IDD Continue reading >>
Tailoring Treatment To Reduce Disparities:
The American Diabetes Association (ADA) publishes the Standards of Medical Care in Diabetes annually, based on the latest medical research. The following narrative provides a summary of the 2017 updated recommendations that have been developed for clinical practice. The ADA guidelines are not intended to aid or preclude clinical judgment. The full guidelines can be accessed at ADA’s Diabetes Pro website. Tailoring Treatment to Reduce Disparities: Updated guidelines focus on improving outcomes and reducing disparities in populations with diabetes such as: Ethnic/Cultural/Sex/Socioeconomic Differences and Disparities: Provide structured interventions that are tailored to ethnic populations and integrate culture, language, religion, and literacy skills. Food Insecurity: Evaluate hyperglycemia and hypoglycemia in the context of food insecurity (FI), which is defined as the unreliable availability of nutritious food. Recognize that homelessness and poor literacy and numeracy often occur with FI. Propose solutions and resources accordingly. Comprehensive Medical Evaluation and Assessment of Comorbidities: The clinical evaluation should include conversation about lifestyle modifications and healthy living. PAs should address barriers including patient factors (e.g., remembering to obtain or take medications, fears, depression, and health beliefs), medication factors (e.g., complex directions, cost) and system factors (e.g., inadequate follow up). Simplifying treatment regimens may improve adherence. This section highlights the elements of a patient-centered comprehensive medical exam, including the importance of assessing comorbidities such as: Cognitive Dysfunction: Tailor glycemic therapy to avoid significant hypoglycemia. Cardiovascular benefits of statin therapy outweigh Continue reading >>
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Diagnosis And Management Of Diabetes: Synopsis Of The 2016 American Diabetes Association Standards Of Medical Care In Diabetes Free
Description: The American Diabetes Association (ADA) published the 2016 Standards of Medical Care in Diabetes (Standards) to provide clinicians, patients, researchers, payers, and other interested parties with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Methods: The ADA Professional Practice Committee performed a systematic search on MEDLINE to revise or clarify recommendations based on new evidence. The committee assigns the recommendations a rating of A, B, or C, depending on the quality of evidence. The E rating for expert opinion is assigned to recommendations based on expert consensus or clinical experience. The Standards were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community was incorporated into the 2016 revision. Recommendations: The synopsis focuses on 8 key areas that are important to primary care providers. The recommendations highlight individualized care to manage the disease, prevent or delay complications, and improve outcomes. Since 1989, the American Diabetes Association (ADA) Standards of Medical Care in Diabetes (Standards) have provided the framework for evidence-based recommendations to treat patients with diabetes. This synopsis of the 2016 ADA Standards highlights 8 areas that are important to primary care providers: diagnosis, glycemic targets, medical management, hypoglycemia, cardiovascular risk factor management, microvascular disease screening and management, and inpatient diabetes management. Guideline Development and Evidence Grading Recommendations for Glycemic Targets Medical Management of Diabetes Type 1 Diabetes Type 2 Diabetes Cardiovascu Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- New ADA 2017 Standards of Medical Care in Diabetes
- What to Know About the ADA's 2018 Standards of Medical Care if You Have Diabetes
2. Classification And Diagnosis Of Diabetes: Standards Of Medical Care In Diabetes2018
2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes2018 A1C 5.76.4% (3947 mmol/mol) or 10% increase in A1C FPG 126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h. * 2-h PG 200 mg/dL (11.1 mmol/L) during OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75-g anhydrous glucose dissolved in water. * A1C 6.5% (48 mmol/mol). The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay. * In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose 200 mg/dL (11.1 mmol/L). * In the absence of unequivocal hyperglycemia, results should be confirmed by repeat testing. Criteria for testing for diabetes or prediabetes in asymptomatic adults 1. Testing should be considered in overweight or obese (BMI 25 kg/m2 or 23 kg/m2 in Asian Americans) adults who have one or more of the following risk factors: High-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander) Hypertension (140/90 mmHg or on therapy for hypertension) HDL cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L) Other clinical conditions associated with insulin resistance (e.g., severe obesity, acanthosis nigricans) 2. Patients with prediabetes (A1C 5.7% [39 mmol/mol], IGT, or IFG) should be tested yearly. 3. Women who were diagnosed with GDM should have lifelong testing at least every 3 years. 4. For all other patients, testing should begin at age 45 years. 5. If results are normal, testing should be repeated at a minimum of 3-year intervals, with consideration of more frequent testing depending on initial results and Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- New ADA 2017 Standards of Medical Care in Diabetes
- What to Know About the ADA's 2018 Standards of Medical Care if You Have Diabetes
2. Classification And Diagnosis Of Diabetes
Stage 1 Stage 2 Stage 3 Stage • Autoimmunity • Normoglycemia • Presymptomatic • Autoimmunity • Dysglycemia • Presymptomatic • New-onset hyperglycemia • Symptomatic Diagnostic criteria • Multiple autoantibodies • No IGT or IFG • Multiple autoantibodies • Dysglycemia: IFG and/or IGT • FPG 100–125 mg/dL (5.6–6.9 mmol/L) • 2-h PG 140–199 mg/dL (7.8–11.0 mmol/L) • A1C 5.7–6.4% (39–47 mmol/mol) or ≥10% increase in A1C • Clinical symptoms • Diabetes by standard criteria FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h.* OR 2-h PG ≥200 mg/dL (11.1 mmol/L) during an OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water.* OR A1C ≥6.5% (48 mmol/mol). The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.* OR In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L). 1. Testing should be considered in overweight or obese (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) adults who have one or more of the following risk factors: A1C ≥5.7% (39 mmol/mol), IGT, or IFG on previous testing • first-degree relative with diabetes • high-risk race/ethnicity (e.g., African American, Latino, Native American, Asian American, Pacific Islander) • women who were diagnosed with GDM • history of CVD • hypertension (≥140/90 mmHg or on therapy for hypertension) • HDL cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L) • women with polycystic ovary syndrome • physical inactivity • other clinical conditions associated wi Continue reading >>
The American Diabetes Associations New Standards For Diabetes Care | Grant | British Journal Of Diabetes
The American Diabetes Associations new standards for diabetes care Diabetes care remains difficult in the sense that it can be poorly coordinated, overly clinician-centred, non-standardised, lacking in the right sort of evidence base and isnt integrated from a service users perspective.1,2 Do you agree? Do you run a good diabetes service? Have we successfully implemented ongoing patient self-management and education programmes and do our multidisciplinary teams offer the right type of support? If you were diagnosed with diabetes tomorrow, what type of care would you expect nay demand? The American Diabetes Association approach Looking across the Atlantic, it is very interesting to read the latest position and scientific statements from the American Diabetes Association (ADA) in terms of their Standards of medical care in diabetes.3 They state that the goal of the standards is to ensure that clinicians, health plans and policy makers can continue to rely on them as the most authoritative and current guidelines for diabetes care and they include key clinical practice recommendations, using grade A or B evidence from up-to-date research. See how many of the following you agree with or have already put into practice. A patient-centred communication style. Timely treatment decisions, supported by evidence-based guidelines. Care should be aligned with the chronic care model (to ensure proactive interactions between a prepared proactive team and an informed activated patient). Care systems should support team-based care, community involvement, patient registries and decision support tools to meet patient needs. 2. Classification and diagnosis of diabetes (pre-diabetes) Testing to assess future risk of diabetes in an asymptomatic individual should be considered in those who ar Continue reading >>
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New Ada Guidelines For Diagnosis, Screening Of Diabetes
The American Diabetes Association now includes hemoglobin A1c in its diagnosis guidelines. In 2010, it got a little easier to diagnose diabetes. Diabetes mellitus is a chronic disorder of glucose metabolism that affects 23.6 million people in the U.S.1 The four major types of diabetes differ in their causes, but all types have hyperglycemia in common. These are type 1 (formerly called insulin dependent or juvenile diabetes), type 2, gestational diabetes mellitus (GDM) and diabetes due to other causes. Chronic complications common to all forms include retinopathy, nephropathy, neuropathy and cardiovascular disease. Individuals who are able to keep their blood glucose close to the normal range have the lowest risk of microvascular complications;2,3 managing lipidemia and hypertension improves macrovascular outcomes as well.4 Early diagnosis affords early intervention. Diagnosis of diabetes has historically been by measuring fasting plasma glucose (FPG) or performing an oral glucose tolerance test (OGTT); specific threshold values are required to categorize an individual as pre-diabetic (increased risk for diabetes) and diabetic (Table 1). For individuals without unequivocal hyperglycemia, positive results must be repeated on a separate day.5 Type 2 Diabetes Type 2 diabetes accounts for 90-95% of the cases in the U.S. Risk factors are obesity and being overweight, race, age, family history, hypertension, gestational diabetes and physical inactivity.6 Individuals with symptoms such as blurred vision, polydipsia and polyuria should be tested when they present with these symptoms.7 Asymptomatic individuals with risk factors should be screened for diabetes if they are overweight (BMI > 25 kg/m2) and have additional risk factors,5 or beginning at age 45 for those without other Continue reading >>
Treating Diabetes Requires A Multifaceted Approach
Treating Diabetes Requires a Multifaceted Approach Diabetes afflicts more than 30 million Americans.1 There are also an estimated 84 million people in the United States who are pre-diabetic, with elevated blood glucose levels, and at risk for developing the disease.1 This complex, chronic disease requires a multifaceted approach to management that combines education and support, lifestyle modifications, and pharmacological treatment. Diabetes consists of a group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.2 Symptoms include blurred vision, extreme fatigue, polydipsia, polyphagia, polyuria, weight loss, and yeast infections.3 Type 1 diabetes (T1D), often called insulin-dependent or immune-mediated diabetes, is usually diagnosed in children or young adults but can develop at any age. About 5% to 10% of those affected by diabetes have T1D, which develops because of the cellular-mediated autoimmune destruction of the beta cells in the pancreas.2,4 Beta-cell destruction can be variable; it is rapid in some individuals and slow in others. Because of the severe insulin deficiency, exogenous insulin is required to control blood glucose and prevent diabetic ketoacidosis. Often, the first symptom of T1D is the presentation of ketoacidosis. In other patients, moderate fasting glucose may quickly change to ketoacidosis in the presence of infection or stress. Yet others can maintain enough residual beta-cell function to prevent ketoacidosis for years. Risk factors for T1D are not very clear, but genetic and environmental components appear to be involved. Type 2 diabetes (T2D), or insulin-resistant diabetes, is the most common type, representing 90% to 95% of patients with diabetes. It is characterized by Continue reading >>
Ada Updates Diagnosis And Classification Standards
ADA Updates Diagnosis and Classification Standards The American Diabetes Association's Professional Practice Committee, in a recent release, highlighted changes in classification and diagnosis for the 2018 Standards of Medical Care in Diabetes. One of the updates includes the following summary of current diabetes diagnostic categories, most of which are familiar; however, it includes additional consideration of diabetes due to other, less recognized causes (bolded below): Type 1 diabetes (due to autoimmune beta-cell destruction, usually leading to absolute insulin deficiency) Type 2 diabetes (due to a progressive loss of beta-cell insulin secretion, frequently on the background of insulin resistance) Gestational diabetes mellitus (GDM) (diabetes diagnosed in the second or third trimester of pregnancy that was not clearly overt diabetes prior to gestation) Specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), diseases of the exocrine pancreas (such as cystic fibrosis and pancreatitis), and drug- or chemical-induced diabetes (such as with glucocorticoid use, in the treatment of HIV/AIDS, or after organ transplantation) Chief Scientific, Medical and Mission Officer William T. Cefalu, MD, stated in a recent press release , Since 1989, the American Diabetes Association has provided annual updates to the Standards of Care, and the Standards are accepted as the global standard for diabetes care. As new technology, research and treatments continue to improve and emerge, we are pleased that we will have the capacity to provide real-time updates to the Standards of Care throughout the year. An additional focus in the 2018 Standards has also been placed on new evidence descri Continue reading >>
Abnormal Glucose Tolerance Post-gestational Diabetes Mellitus As Defined By The International Association Of Diabetes And Pregnancy Study Groups Criteria
Abstract Objective An increase in gestational diabetes mellitus (GDM) prevalence has been demonstrated across many countries with adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Here, we determine the cumulative incidence of abnormal glucose tolerance among women with previous GDM, and identify clinical risk factors predicting this. Design Two hundred and seventy women with previous IADPSG-defined GDM were prospectively followed up for 5years (mean 2.6) post-index pregnancy, and compared with 388 women with normal glucose tolerance (NGT) in pregnancy. Methods Cumulative incidence of abnormal glucose tolerance (using American Diabetes Association criteria for impaired fasting glucose, impaired glucose tolerance and diabetes) was determined using the Kaplan–Meier method of survival analysis. Cox regression models were constructed to test for factors predicting abnormal glucose tolerance. Results Twenty-six percent of women with previous GDM had abnormal glucose tolerance vs 4% with NGT, with the log-rank test demonstrating significantly different survival curves (P<0.001). Women meeting IADPSG, but not the World Health Organization (WHO) 1999 criteria, had a lower cumulative incidence than women meeting both sets of criteria, both in the early post-partum period (4.2% vs 21.7%, P<0.001) and at longer-term follow-up (13.7% vs 32.6%, P<0.001). Predictive factors were glucose levels on the pregnancy oral glucose tolerance test, family history of diabetes, gestational week at testing, and BMI at follow-up. Conclusions The proportion of women developing abnormal glucose tolerance remains high among those with IADPSG-defined GDM. This demonstrates the need for continued close follow-up, although the optimal fr Continue reading >>
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:: Dmj :: Diabetes & Metabolism Journal
Diabetes Metab J. 2018 Feb;42(1):87-89. English. Published online Feb 23, 2018. Copyright 2018 Korean Diabetes Association Letter: Adipokines and Insulin Resistance According to Characteristics of Pregnant Women with Gestational Diabetes Mellitus (Diabetes Metab J 2017;41:457-65) Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea. Corresponding author: Ohk-Hyun Ryu. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon 24253, Korea. Email: [email protected] This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( nc/4.0/ ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes Care 2018;41 Suppl 1:S13S27. Cho GJ, Kim LY, Sung YN, Kim JA, Hwang SY, Hong HR, Hong SC, Oh MJ, Kim HJ. Secular trends of gestational diabetes mellitus and changes in its risk factors. PLoS One 2015;10:e0136017 Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005;352:24772486. Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005;115:e290e296. Handwerger S, Fre Continue reading >>
A Summary Of Adas Recent 2018 Standards Of Medical Care In Diabetes
Access , CDE , Cost of Care , Diabetes , Diabetes Education , Diabetes Management , Healthcare Management , Support , Type 1 Diabetes , Type 2 Diabetes , medical care For diabetes healthcare workers, part of ringing in the new year is reviewing the American Diabetes Association (ADA) Updated Diabetes Standards of Medical Care. Each year, a professional practice committee reviews evidence that has come out since the previous edition, providing recommendations for best practices in diabetes care. For those who have not yet had a chance to review the 2018 Standards, here is the cliff notes version, particularly as the updates relate to Certified Diabetes Educators (CDEs). The first update relates to the Standards of Care document overall. While this document will continue to be updated annually, there will now be an online version that is updated more frequently as needed (Professional.diabetes.org/SOC). In addition, the ADA will begin accepting proposals from the community for statements, consensus reports, scientific reviews, etc. CDEs would benefit from this opportunity to suggest topics for in-depth review that will further the evidence related to our effective support for patient self-management. The Standards of Care includes 15 chapters, to provide a comprehensive overview of evidence-based management of diabetes. While there are no major changes in the 2018 version, there are minor updates worth noting. Chapter 1 of the document, previously entitled Strategies for Improving Care, has been renamed Promoting Health and Reducing Disparities. This chapter includes a new recommendation that providers consider the burden of treatment and the self-efficacy of patients when recommending treatments. This chapter also discusses the importance of tailoring diabetes treatment Continue reading >>
- A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- What to Know About the ADA's 2018 Standards of Medical Care if You Have Diabetes
2. Classification And Diagnosis Of Diabetes
2. Classification and Diagnosis of Diabetes This article has a correction. Please see: Diabetes can be classified into the following general categories: Type 1 diabetes (due to -cell destruction, usually leading to absolute insulin deficiency) Type 2 diabetes (due to a progressive loss of insulin secretion on the background of insulin resistance) Gestational diabetes mellitus (GDM) (diabetes diagnosed in the second or third trimester of pregnancy that is not clearly overt diabetes) Specific types of diabetes due to other causes, e.g., monogenic diabetes syndromes (such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), diseases of the exocrine pancreas (such as cystic fibrosis), and drug- or chemical-induced diabetes (such as with glucocorticoid use, in the treatment of HIV/AIDS or after organ transplantation) This section reviews most common forms of diabetes but is not comprehensive. For additional information, see the American Diabetes Association (ADA) position statement Diagnosis and Classification of Diabetes Mellitus (1). Type 1 diabetes and type 2 diabetes are heterogeneous diseases in which clinical presentation and disease progression may vary considerably. Classification is important for determining therapy, but some individuals cannot be clearly classified as having type 1 or type 2 diabetes at the time of diagnosis. The traditional paradigms of type 2 diabetes occurring only in adults and type 1 diabetes only in children are no longer accurate, as both diseases occur in both cohorts. Occasionally, patients with type 2 diabetes may present with diabetic ketoacidosis (DKA). Children with type 1 diabetes typically present with the hallmark symptoms of polyuria/polydipsia and approximately one-third with DKA (2). The onset of type 1 diabete Continue reading >>
2018 Ada Standards Of Care
ISSN 0149-5992TH E JOU R NAL OF C LI N ICAL AN D APPLI ED R ESEARC H AN D EDUCATIONWWW.DIABETES.ORG/DIABETESCARE JANUARY 2018VOLUME 41 | SUPPLEMENT 1A M E R I C A N D I A B E T E S A S S O C I A T I O NSTANDARDS OFMEDICAL CAREIN DIABETES2018SUPPLEMENT1[T]he simple word Care may sufce to express [the journals] philosophicalmission. The new journal is designed to promote better patient care byserving the expanded needs of all health professionals committed to the careof patients with diabetes. As such, the American Diabetes Association viewsDiabetes Care as a reafrmation of Francis Weld Peabodys contention thatthe secret of the care of the patient is in caring for the patient.Norbert Freinkel, Diabetes Care, January-February 1978EDITOR IN CHIEFMatthew C. Riddle, MDASSOCIATE EDITORSGeorge Bakris, MDLawrence Blonde, MD, FACPAndrew J.M. Boulton, MDDavid DAlessio, MDMary de Groot, PhDEddie L. Greene, MDFrank B. Hu, MD, MPH, PhDSteven E. Kahn, MB, ChBSanjay Kaul, MD, FACC, FAHADerek LeRoith, MD, PhDRobert G. Moses, MDStephen Rich, PhDJulio Rosenstock, MDWilliam V. Tamborlane, MDJudith Wylie-Rosett, EdD, RDEDITORIAL BOARDNicola Abate, MDVanita R. Aroda, MDGeremia Bolli, MDJohn B. Buse, MD, PhDRobert J. Chilton, DO, FACC, FAHAKenneth Cusi, MD, FACP, FACEParesh Dandona, MD, PhDJ. Hans DeVries, MD, PhDEle Ferrannini, MDFranco Folli, MD, PhDMeredith A. Hawkins, MD, MSRichard Hellman, MDNorbert Hermanns, PhD, MScIrl B. Hirsch, MD, MACPGeorge S. Jeha, MDLee M. Kaplan, MD, PhDM. Sue Kirkman, MDIldiko Lingvay, MD, MPH, MSCSHarold David McIntyre, MD, FRACPMaureen Monaghan, PhD, CDEKristen J. Nadeau, MD, MSKwame Osei, MDKevin A. Peterson, MD, MPH, FRCS(Ed),FAAFPJonathan Q. Purnell, MDPeter Reaven, MDRavi Retnakaran, MD, MSc, FRCPCHelena Wachslicht Rodbard, MDElizabeth Seaquist, MDGuntra Continue reading >>
2018 Standards Of Medical Care In Diabetes
2018 Standards of Medical Care in Diabetes Home // ... // Clinical Laboratory News // CLN Stat // 2018 Standards of Medical Care in Diabetes 2018 Standards of Medical Care in Diabetes In annual update ADA revises glycemic targets, screening protocols, expands recommendations for continuous glucose monitoring in adults. The American Diabetes Association (ADA) in its 2018 Standards of Medical Care in Diabetes is recommending continuous glucose monitoring (CGM) to all adults 18 and over who arent meeting glycemic targets, as well as screening high-risk youths for type 2 diabetes. The revised guidelines, published in Diabetes Care, also created new specifications for applying the HbA1c (A1C) test. Since 1989, the American Diabetes Association has provided annual updates to theStandards of Care, and the Standards are accepted as the global standard for diabetes care, said ADAs Chief Scientific, Medical and Mission Officer William T. Cefalu, MD, in a statement . ADA plans on updating this document throughout the year in light of new technology, research, and therapy developments, Cefalu said. Two sections in this guidanceclassification and diagnosis of diabetes and glycemic targetsspecifically address the limitations of A1C measurements. A number of different factors can affect the results of this test, including assay interference, hemoglobin variants, and variations in red blood cell turnover rates, as well as age, pregnancy, and ethnicity. ADA clarified how A1C should be used to help diagnose and monitor diabetes, recommending that clinicians use alternatives such as fasting plasma glucose or oral glucose tolerance tests in the event that A1C results and blood glucose levels dont agree. The guidance suggested that A1C testing take place just twice a year in patients who a Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- What to Know About the ADA's 2018 Standards of Medical Care if You Have Diabetes
- A Summary of ADA’s New 2018 Standards of Medical Care in Diabetes
