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Who Criteria For Diabetes 2017

Ads Position Statement On The Prevention And Management Of Type 2 Diabetes In The Context Of Serious Mental Illness

Ads Position Statement On The Prevention And Management Of Type 2 Diabetes In The Context Of Serious Mental Illness

Authors: Roger Chen, Timothy Lambert, Jen Kinsella, Leon Chapman, Maarten Kamp, Jennifer Conn The Australian Diabetes Society (ADS) has released a new position statement aimed at improving the management and health outcomes of people living with serious mental illness and type 2 diabetes. A working party, supported by funding from the National Diabetes Services Scheme, was established to provide recommendations for the improvement and to better monitoring of the overall cardiometabolic health, particularly diabetes and diabetes risk, of individuals with serious mental illness. Download the full version of 'The prevention and management of type 2 diabetes in the context of psychotic disorders ADS Position Statement' - PDF (Posted: October, 2017) ADS Position Statement on Insulin-requiring Diabetes and Recreational Diving Authors: Mervyn Kyi, Barbora Paldus, Natalie Nanayakkara, Michael Bennett, Rebecca Johnson, Catherine Meehan, Peter Colman In 2015 the Australian Diabetes Society commissioned a working group to review and revise its position statement on scuba diving in persons with diabetes. The working group consisted of endocrinologists with an interest in type 1 diabetes, diving medical specialists, a recreational diver with diabetes and an advocate for people with type 1 diabetes. A thorough literature review was performed and all available evidence was summarised and a new position statement was drafted. The new position statement was submitted to the ADS Council for approval. The scope of this document is restricted to recreational (not professional) diving in line with the available evidence. It is also targeted at insulin-requiring (both type 1 and type 2) diabetes, as traditionally this group has been excluded from recreational diving. This document updates th Continue reading >>

Clinical Presentation And Diagnosis Of Diabetes Mellitus In Adults

Clinical Presentation And Diagnosis Of Diabetes Mellitus In Adults

INTRODUCTION The term diabetes mellitus describes several diseases of abnormal carbohydrate metabolism that are characterized by hyperglycemia. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin. Every few years, the diabetes community reevaluates the current recommendations for the classification, diagnosis, and screening of diabetes, reflecting new information from research and clinical practice. The American Diabetes Association (ADA) issued diagnostic criteria for diabetes mellitus in 1997, with follow-up in 2003 and 2010 [1-3]. The diagnosis is based on one of four abnormalities: glycated hemoglobin (A1C), fasting plasma glucose (FPG), random elevated glucose with symptoms, or abnormal oral glucose tolerance test (OGTT) (table 1). Patients with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) are referred to as having increased risk for diabetes or prediabetes. (See 'Diagnostic criteria' below.) Screening for and prevention of diabetes is reviewed elsewhere. The etiologic classification of diabetes mellitus is also discussed separately. (See "Screening for type 2 diabetes mellitus" and "Prevention of type 2 diabetes mellitus" and "Prevention of type 1 diabetes mellitus" and "Classification of diabetes mellitus and genetic diabetic syndromes".) CLINICAL PRESENTATION Type 2 diabetes is by far the most common type of diabetes in adults (>90 percent) and is characterized by hyperglycemia and variable degrees of insulin deficiency and resistance. The majority of patients are asymptomatic, and hyperglycemia is noted on routine laboratory evaluation, prompting further testing. The frequency of symptomatic diabetes has been decreasing in parallel wi Continue reading >>

Standards Of Medical Care In Diabetes—2017

Standards Of Medical Care In Diabetes—2017

GENERAL CHANGES In light of the American Diabetes Association’s (ADA’s) new position statement on psychosocial care in the treatment of diabetes, the “Standards of Medical Care in Diabetes,” referred to as the “Standards of Care,” has been updated to address psychosocial issues in all aspects of care including self-management, mental health, communication, complications, comorbidities, and life-stage considerations. Although levels of evidence for several recommendations have been updated, these changes are not addressed below as the clinical recommendations have remained the same. Changes in evidence level from, for example, E to C are not noted below. The 2017 Standards of Care contains, in addition to many minor changes that clarify recommendations or reflect new evidence, the following more substantive revisions. SECTION CHANGES This section was renamed and now focuses on improving outcomes and reducing disparities in populations with diabetes. Recommendations were added to assess patients’ social context as well as refer to local community resources and provide self-management support. Section 2. Classification and Diagnosis of Diabetes The section was updated to include a new consensus on the staging of type 1 diabetes (Table 2.1) and a discussion of a proposed unifying diabetes classification scheme that focuses on β-cell dysfunction and disease stage as indicated by glucose status. Language was added to clarify screening and testing for diabetes. Screening approaches were described, and Fig. 2.1 was included to provide an example of a validated tool to screen for prediabetes and previously undiagnosed type 2 diabetes. Due to recent data, delivering a baby weighing 9 lb or more is no longer listed as an independent risk factor for the development o Continue reading >>

Guidelines

Guidelines

There is now extensive evidence on the optimal management of diabetes, offering the opportunity of improving the immediate and long-term quality of life of those living with the condition. Unfortunately such optimal management is not reaching many, perhaps the majority, of the people who could benefit. Reasons include the size and complexity of the evidence-base, and the complexity of diabetes care itself. One result is a lack of proven cost-effective resources for diabetes care. Another result is diversity of standards of clinical practice. Guidelines are part of the process which seeks to address those problems. IDF has produced a series of guidelines on different aspects of diabetes management, prevention and care. The new IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care seek to summarise current evidence around optimal management of people with type 2 diabetes. It is intended to be a decision support tool for general practitioners, hospital based clinicians and other primary health care clinicians working in diabetes. Pocket chart in the format of a Z-card with information for health professionals to identify, assess and treat diabetic foot patients earlier in the "window of presentation" between when neuropathy is diagnosed and prior to developing an ulcer. The content is derived from the IDF Clinical Practice Recommendations on the Diabetic Foot 2017. Available to download and to order in print format. The IDF Clinical Practice Recommendations on the Diabetic Foot are simplified, easy to digest guidelines to prioritize health care practitioner's early intervention of the diabetic foot with a sense of urgency through education. The main aims of the guidelines are to promote early detection and intervention; provide the criteria for Continue reading >>

Tailoring Treatment To Reduce Disparities:

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 >>

Wisconsin Diabetes Mellitus Essential Care Guidelines

Wisconsin Diabetes Mellitus Essential Care Guidelines

Diabetes Care Guidelines The Wisconsin Diabetes Advisory Group recommends use of the American Diabetes Association (ADA) Clinical Practice Recommendations (link is external) for guidance on high-quality, evidence-based diabetes clinical care. The ADA also offers an abridged version for primary care providers, Standards of Medical Care in Diabetes: Abridged for Primary Care Providers (link is external). ADA Clinical Practice Recommendations are based on a complete review of the relevant literature by a diverse group of highly trained clinicians and researchers. After weighing the quality of evidence, from rigorous double-blind clinical trials to expert opinion, recommendations are drafted, reviewed, and submitted for approval to the ADA Executive Committee; they are then revised on a regular basis, and published annually in Diabetes Care. Wisconsin Provider Supplements for Diabetes Care Patient Education Materials Diabetes Self-Care Booklet: This 12-page booklet explains diabetes, diabetes self-care, and lists the tests, exams, and medical checks you need to have in order to take care of your diabetes. Personal Diabetes Care Record: This two-page wallet card provides a place for the person with diabetes to record tests, exams, and medical checks necessary for good self-management. Blood Sugar Log Booklet: This booklet provides a place to record three months of blood sugar test results. All Diabetes Prevention and Control Program resources are copyright-free. Please duplicate and distribute as many copies of these materials as needed. Continue reading >>

Ada 2017 Guidelines Ppt

Ada 2017 Guidelines Ppt

The Dental Quality Alliance (DQA) Overview and Work of the DQA. June 12, 2017; San Diego, CA. • BP >120/80. Individualized treatment is the cornerstone of success. As such, the American Diabetes Association views. Diagnosing Diabetes. ACCF=American College of Cardiology Foundation, ADA=American Diabetes Association, AHA=American Heart Association, CV=Cardiovascular, CVD=Cardiovascular disease, the ADA does not include that recommendation in its guidelines. 17%. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values DRA. Sulfonylureas. ampmd. While the ADA guidelines acknowledge that approximately 10% of patients with DKA present with lower glucose levels, they emphasize that the key diagnostic feature of DKA is . 18%. 5 million Americans receive a new diagnosis of diabetes. American Diabetes Association 2017 Guidelines-What's New. Victoza® - LEADER - Alan Moses, SVP and Chief Medical Officer. AACE/ACE vs ADA: The Clinical Dilemma of. Presented at the 77th Scientific Sessions of the American 7. Process. . Understand the relationship between diabetes and kidney . 7 Adamsson Eryd S, Gudbjörnsdottir S, Manhem K, et al. Presented at the 77th Scientific Sessions of the American Diabetes Association;. com. The main aims of the guidelines 15 Dec 2016 The American Diabetes Associa- tion's (ADA's) Standards of Med- ical Care in Diabetes is updated and published annually in a supple- ment to the January issue of Diabetes. on the 2017 Standards of Care are invited to do so at Page 2 of 3. PowerPoint Presentation. <7%. Oral Health and Well-Being in the United States. Searched Medline for human studies related to each subsection and published since January 1, 2 Continue reading >>

Acog Releases Updated Guidance On Gestational Diabetes

Acog Releases Updated Guidance On Gestational Diabetes

SUMMARY: ACOG has released updated guidance on gestational diabetes (GDM), which has become increasingly prevalent worldwide. Highlights and changes from the previous practice bulletin include the following: Fetal Monitoring Screening for GDM – One or Two Step? ACOG (based on NIH consensus panel findings) still supports the ‘2 step’ approach (24 – 28 week 1 hour venous glucose measurement following 50g oral glucose solution), followed by a 3 hour oral glucose tolerance test (OGTT) if positive Note: While the diagnosis of GDM is based on 2 abnormal values on the 3 hour OGTT, ACOG states, due to known adverse events, one abnormal value may be sufficient to make the diagnosis 1 step approach (75 g OGTT) on all women will increase the diagnosis of GDM but sufficient prospective studies demonstrating improved outcomes still lacking ACOG does acknowledge that some centers may opt for ‘1 step’ if warranted based on their population Who Should be Screened Early? ACOG has adopted the NIDDK / ADA guidance on screening for diabetes and prediabetes which takes in to account not only previous pregnancy history but also risk factors associated with type 2 diabetes. Screen early in pregnancy if: Patient is overweight with BMI of 25 (23 in Asian Americans), and one of the following: Physical inactivity Known impaired glucose metabolism Previous pregnancy history of: GDM Macrosomia (≥ 4000 g) Stillbirth Hypertension (140/90 mm Hg or being treated for hypertension) HDL cholesterol ≤ 35 mg/dl (0.90 mmol/L) Fasting triglyceride ≥ 250 mg/dL (2.82 mmol/L) PCOS, acanthosis nigricans, nonalcoholic steatohepatitis, morbid obesity and other conditions associated with insulin resistance Hgb A1C ≥ 5.7%, impaired glucose tolerance or impaired fasting glucose Cardiovascular disea Continue reading >>

Ada Guidelines 2017 Ppt

Ada Guidelines 2017 Ppt

Rhinehart, MD; Jay H. Table 3. The committee is a multi-disciplinary team of 12 leading experts in 15 Dec 2016 The American Diabetes Associa- tion's (ADA's) Standards of Med- ical Care in Diabetes is updated and published annually in a supple- ment to the January issue of Diabetes. Close. Diabetes Care. Timely and accurate 31 Mar 2017 www. Currently, there are a number of country-specific guidelines on diagnosis and treatment of Gdm. fda. 10 new. ADA 2017. adverse events using the ADA recommendations. 35%. N. 1 Psychological health, access to care, expanded and personalized treatment options and the tracking of hypoglycemia emphasized. Sulfonylureas; Biguanides; Thiazolidinediones “Glitazones”; Meglitinides; DPP-4 Inhibitors; Incretin Memetics; Insulin. This presentation is provided for informational purposes only and is not intended and should not be construed to constitute legal advice. •. Key changes in ADA Updates Standards of Medical Care for Patients with Diabetes Mellitus. 18%. Jan 6, 2017 [T]he simple word Care may suffice to express [the journal's] philosophical mission. N. Managing T2D in 2017. HR. Diabetes Care 2017; 40 (Suppl. Published annually in the journal Diabetes Care, the American Diabetes Association (ADA) guidelines are diabetes-related clinical practice recommendations covering diabetes diagnosis, Type 1 Diabetes Diagnosis Follow-Up ADA Guidelines | NDEI PPT Type 2 Diabetes & CVD Risk AHA ADA Guidelines PPT | NDEI. 2017. George A. Endocrinologists' Comprehensive Diabetes Management Algorithm 2013; International Diabetes. DIABETES. 3. AMERICAN DIABETES ASSOCIATION. 00033. ca/browse/appendices/appendix3. 2. AACE Clinical Practice Guidelines for Diabetes Mellitus Writing Committee Task Force. Bailey, MD, FACP, FACE, ECNU. 2015 Update. The commit Continue reading >>

Ada Releases 2017 Standards Of Medical Care In Diabetes

Ada Releases 2017 Standards Of Medical Care In Diabetes

The American Diabetes Association has released it’s 2017 Standards of Medical Care in Diabetes. The Standards of Care are comprised of a committee of a dozen leading experts in diabetes care who annually review all the available research on diabetes and then rate recommendations based on that evidence-based clinical support. The guidelines focus on screening, diagnosis and treatment in order to help improve outcomes for people of all ages with type 1 or type 2 diabetes including women with gestational diabetes and the prevention and delay of type 2 diabetes development. The 2017 Standards of Medical Care in Diabetes highlight several issues including psychosocial care, physical fitness, metabolic surgery, and low blood sugar. Robert E Ratner, MD, FACP, FACE, the ADA’s Chief Scientific and Medical Officer said in the Association’s press release that this year’s Standards lead a multifaceted approach to give a “comprehensive, individualized diabetes care plan” for people with diabetes. 2017 Standards of Care Highlights More Attention to Psychological Health and Comorbidities Due to the heavy psychological and emotional burden from diabetes, the 2017 Standards have included guidelines on screening patients with diabetes for “diabetes distress”, depression, anxiety, and eating disorders. They have also included a list of situations that should prompt mental health specialist referral for the patient. Assessing comorbidities, which are conditions a patient lives with aside from their diabetes is recommended as part of a “comprehensive patient-centered evaluation. The list of comorbidities has been modified to now include autoimmune disease, HIV, anxiety disorders, depression, disordered eating behavior, and serious mental illness. Lifestyle Management The 2 Continue reading >>

Highlights From The American Diabetes Association's 2017 Standards Of Medical Care In Diabetes For Osteopathic Physicians

Highlights From The American Diabetes Association's 2017 Standards Of Medical Care In Diabetes For Osteopathic Physicians

The American Diabetes Association (ADA) updates its Standards of Medical Care (SOMC) in Diabetes annually. These ADA standards make up a comprehensive document that serves as an excellent resource for clinical care. The current article comes from the ADA's Primary Care Advisory Group. This article highlights key aspects of the SOMC that are relevant to the day-to-day practice of osteopathic primary care physicians. It is not intended to replace the full SOMC but will refer to the master document for further explanation and evidence-based support. Continue reading >>

New Ada Guidelines For Diagnosis, Screening Of Diabetes

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 >>

New Ada 2017 Standards Of Medical Care In Diabetes

New Ada 2017 Standards Of Medical Care In Diabetes

Psychological health, access to care, expanded and personalized treatment options and the tracking of hypoglycemia emphasized. The ADA Standards of Medical Care in Diabetes are established and revised annually by a Professional Practice Committee. The committee is a multi-disciplinary team of 12 leading experts in the field of diabetes care, and includes physicians, diabetes educators, registered dietitians and others who have experience in areas that include adult and pediatric endocrinology, epidemiology, public health, lipid research, hypertension, preconception planning and pregnancy care. Members of the committee must disclose potential conflicts of interest with industry and/or other relevant organizations. Psychological health, access to care, expanded and personalized treatment options, and the tracking of hypoglycemia in people with diabetes are key areas emphasized in the American Diabetes Association’s (Association) new 2017 Standards of Medical Care in Diabetes (Standards). Produced annually by the Association, the guidelines focus on screening, diagnosis and treatment to provide better health outcomes for children, adults and older people with type 1, type 2 or gestational diabetes, and to improve the prevention and delay of type 2 diabetes. The Standards were published as a supplement to the January 2017 issue of Diabetes Care. The Standards also include the findings of a new report on diabetes staging, titled “Differentiation of Diabetes by Pathophysiology, Natural History and Prognosis” (Differentiation), which is being published at the same time in Diabetes. Produced by a joint symposium of the Association, JDRF, the European Association for the Study of Diabetes and the American Association of Clinical Endocrinologists, the Differentiation report Continue reading >>

Diabetes: A Diabetes Mellitus Guideline Gone Wrong — The 2017 Acp Update

Diabetes: A Diabetes Mellitus Guideline Gone Wrong — The 2017 Acp Update

An recent update on the 2012 ACP diabetes mellitus guidelines relies on a formal review, which excluded studies in which standard of care was the comparator, and thus excludes most of the key randomized controlled trials in the diabetes arena. An over-reliance on confounded observational studies is a consequence, limiting the usefulness of this update. Additional access options: Already a subscriber? Log in now or Register for online access. Garber, A. J. et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm — 2016 executive summary. Endocr. Pract. 22, 84–113 (2016). Inzucchi, S. E. et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 38, 140–149 (2015). The author is grateful to discussions in previous years with those involved with National Institute for Care and Health Excellence (NICE), International Diabetes Federation (IDF) and Canadian diabetes guidelines. The author or institutions with which he is associated have received funding for advisory, lecturing or research activities from Antriabio, AstraZeneca, Biocon, Eli Lilly, GlaxoSmithKline, Hanmi, Janssen, Merck (MSD), Novo Nordisk and Sanofi. Continue reading >>

Highlights Of Ada 2017 Diabetes Recommendations

Highlights Of Ada 2017 Diabetes Recommendations

Reviewed by Clifton Jackness, MD, Assistant Professor, Hofstra Northwell School of Medicine, New York, NY The American Diabetes Association has released its new guidelines on managing patients with diabetes, entitled Standards Of Medical Care In Diabetes—2017. The revised standards put more emphasis on the psychosocial aspects of the disease, provide new information on viable medication regimens, and highlight the value of screening for prediabetes. Here is a summary of several of the changes. The new guidelines, located here, have been updated to “to address psychosocial issues in all aspects of care including self-management, mental health, communication, complications, comorbidities, and life-stage considerations.”1 For example, they now include a table with information on situations in which patients may need a referral to a mental health provider. Similarly, the section on children and adolescents emphasizes the need to assess and refer youths with psychosocial issues; they also recommend preconception counseling at puberty for all girls of childbearing potential. Despite the new emphasis of psychosocial issues, some of the experts consulted by MedPage Today felt the Association did not go far enough. Gretchen Kubacky, PsyD, a Los Angeles psychologist, said: “Up to one third of diabetes patients also suffer from major depressive disorder. Additionally, a number of psychotropic medications cause weight gain, which may contribute to the development of type 2 diabetes, and the older antipsychotic medications do list diabetes as a potential side effect. I would have liked to have seen a recommendation highlighting the need for closer coordination by MDs and health psychologists, in order to facilitate an overall state of improved health for diabetic patients, Continue reading >>

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