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Who Guidelines For Diabetes 2016

Diagnosis And Management Of Diabetes: Synopsis Of The 2016 American Diabetes Association Standards Of Medical Care In Diabetes Free

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 >>

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 >>

The New 2017 American Diabetes Statement On Standards Of Medical Care In Diabetes: Reducing Cardiovascular Risk In Patients With Diabetes

The New 2017 American Diabetes Statement On Standards Of Medical Care In Diabetes: Reducing Cardiovascular Risk In Patients With Diabetes

The new 2017 American Diabetes Association (ADA) Standards of Medical Care in Diabetes contains recommendations for the management of diabetes and its complications.1 The ADA statement has been updated based on the recent evidence regarding diabetes care and reiterates the focus on the control of traditional modifiable cardiovascular disease (CVD) risk factors through lifestyle and pharmacological interventions. These ADA evidenced-based recommendations for using pharmacological agents to treat risk factors are useful for minimizing CVD risk, taking into consideration the risk-benefit of treatments. In this article, we briefly discuss how the ADA recommendations can help with the management of CVD risk factors among individuals with diabetes. The ADA recommendations place substantial emphasis on the role of lifestyle modifications, including diet and physical activity, for achieving better glycemic control and cardiovascular outcomes. Prior studies have shown that dietary factors influence mealtime insulin dosing and blood glucose levels. High protein (20-30%) and low carbohydrate diet can have salutary effects on fasting blood glucose, postprandial glucose, and insulin response.2 There is no evidence that low protein intake below the recommended daily allowance (0.8 g/kg body weight/day) can delay the reduction in glomerular filtration rate.3,4 Therefore, as part of individualized medical nutrition therapy, carbohydrate, fat, and protein counting should be used to guide flexible insulin therapy. The recent ADA statement has also made separate recommendations for exercise and physical inactivity as two measures of lifestyle behavior. Individuals with diabetes are recommended to perform 150 minutes or more of moderate-to-vigorous physical activity per week (with no two c Continue reading >>

Ada Diabetes Management Guidelines For Children And Adolescents | Ndei

Ada Diabetes Management Guidelines For Children And Adolescents | Ndei

A lower A1C target (<7.0%) is reasonable if it can be achieved without excessive hypoglycemia Plasma glucose before meals (preprandial) Glucose goals should be modified in children with frequent hypoglycemiaor hypoglycemia unawareness If the child is taking basal-bolus therapy, measure postprandial glucose when there is a discrepancy between preprandial glucose values and A1C levels, and to assess preprandial insulin doses Managing Microvascular Complications in Children and Adolescents With Type 1 Diabetes Annual albuminuria screen with a random spot urine sample for ACR with 5-yr diabetes diabetes duration Measure eGFR at initial evaluation and then based on age, diabetes duration, and treatment ACEI* titrated to normalization of albumin excretion if elevated ACR (>30 mg/g) confirmed with 2 of 3 urine samples Obtain samples over 6-month interval after efforts to improve glycemic control and normalize BP Initial dilated and comprehensive eye exam at age 10 yrs or post-puberty onset (whichever occurs first) in children with diabetes duration of 3-5 years Consider annual comprehensive foot exam at age 10 yrs or post-puberty onset (whichever occurs first) in children with diabetes duration of 3-5 years *ACEIs are not approved by the U.S. Food and Drug Administration (FDA) for treatment of nephropathy. Not all ACEIs are indicated for use in children/adolescents by the FDA. Refer to full prescribing information for indications and uses in pediatric populations. Managing High Blood Pressure in Children and Adolescents With Type 1 Diabetes High-normal BP* or hypertension: confirm BP on 3 separate days Lifestyle changes (diet & physical activity) aimed at weight control If target BP is not achieved within 3-6 months, initiate pharmacologic therapy Initial pharmacologic therap Continue reading >>

Type 2 Diabetes: Ada, Aace/ace Update Recommendations

Type 2 Diabetes: Ada, Aace/ace Update Recommendations

The American Diabetes Association (ADA) and American Association of Clinical Endocrinologists, in conjunction with the American College of Endocrinology (AACE/ACE), have released updated recommendations for type 2 diabetes management and care. The documents bring new evidence to bear on standard of care. Screening New in 2016, ADA recommends that all adults aged 45 years and older be screened for type 2 diabetes. “We’ve seen a lot of recent evidence that shows that BMI [body mass index] isn’t necessarily the best corollary for risk. Some people can have a healthy BMI and still develop diabetes,” said Andrew Bzowyckyj, PharmD, BCPS, CDE, coordinator-elect for the APhA Academy of Pharmacy Practice & Management Diabetes Management Special Interest Group. Obesity Both ADA and AACE/ACE added emphasis this year on management of overweight and obesity as a means of treating and delaying type 2 diabetes. Recommendations, which include medication and behavior modification, are not new—but the emphasis is. “Traditionally, ADA has spread its obesity-related recommendations across multiple different areas. Now they’ve devoted a three- to four-page chapter to it. It’s a condensed, easy-to-use resource,” said Bzowyckyj. “The average patient does not appreciate the fact that a 10% weight loss reduces the metabolic risk and cardiovascular complications surrounding diabetes. Pharmacists can make that point,” said Alan Garber, MD, PhD, FACE, chair of the AACE/ACE Algorithm Taskforce. Medications ADA’s recommendation for aspirin therapy now extends to women with type 2 diabetes aged 50 years and older who have at least one other risk factor for cardiovascular disease. “The recommendation reflects new evidence on atherosclerotic cardiovascular disease risk among w Continue reading >>

2018 Aaha Diabetes Management Guidelines Now Available

2018 Aaha Diabetes Management Guidelines Now Available

2018 AAHA Diabetes Management Guidelines now available Accredited-Practice of the Year Award Winners 2015 2018 AAHA Diabetes Management Guidelines now available LAKEWOOD, ColoradoDiabetes management can be overwhelming and time-consuming for both pet owners and practitioners. To help with this challenge, the American Animal Hospital Association (AAHA) is pleased to release its newly revised Diabetes Management Guidelines. Created with an additional focus on empowering veterinary technicians to be a primary source of education and support for owners of diabetic pets, the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats offer important updates to AAHAs 2010 guidelines. Brand-new online tools and educational resources for pet owners and veterinary teams include quick-reference algorithms on diabetes monitoring and troubleshooting; new information on insulin formulations and recommendations for their use; thorough discharge and home monitoring diary templates; how-to videos on insulin administration, capillary blood sampling, and urine glucose testing; and client and staff education materials. By encouraging veterinary technicians to take advantage of these resources to step into a leading role, the guidelines will greatly improve quality of life for diabetic pets and their owners, said AAHA Chief Executive Officer, Michael Cavanaugh, DVM, DABVP (Emeritus). Anything AAHA can do to help motivated, empowered technicians educate and support clients will be an asset to everyone managing diabetic pets. According to Diabetes Management Guidelines Task Force co-chairs, Renee Rucinsky, DVM, DABVP, and Amy Holford, VMD, DACVIM, the guidelines will also help veterinarians better manage their time within the hospital knowing day-to-day diabetes management tasks are in capab Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Facts on glycaemic control in a nutshell Discover general recommendations on the management of diabetes mellitus. ESC and European Association for the Study of Diabetes scientific statements (Ryden L 2013) as well as the most recent ESC Prevention Guideline (Piepoli MF 2016) call on page 2355 for lifestyle management as a first line intervention for the prevention and treatment of diabetes mellitus type 2 (DMT2). In brief: hyperglycaemia is a symptom of multiple causes, and therefore requires a multifactorial approach and thus comprehensive lifestyle changes, especially in DMT2 physical activity is key to increasing caloric expenditure, combatting insulin resistance, reducing hospitalizations and improving the prognosis physical activity supported by sustainable dietary changes improves weight control and, more importantly, induce weight loss strict glycaemic control reduces the risk of microvascular and macrovascular complications; so does a systolic blood pressure ≤140 mmHg, whereas ≤ 130 mmHg even further lessens the risks for stroke, retinopathy and albuminuria and should therefore be the target if tolerated if tight glycaemic and/or blood pressure control are/is not tolerated, temporarily consider relaxed targets in the elderly, frail and / or those with long-term DM and /or cardiovascular disease; however, reconsider stricter targets after timely reassessment statins are recommended in all DMT2 patients >40 years and selected younger patients at high risk in DMT2 with co-existing cardiovascular disease, a sodium-glucose co-transporter-2 (SGLT2) inhibitor should be considered early since it improves prognosis without major adverse effects improved risk factor management reduces cardiovascular mortality in DMT2 – more needs to be done to reach all patients in Continue reading >>

Self-care Sunday: Standards Of Medical Care In Diabetes 2016 Updates

Self-care Sunday: Standards Of Medical Care In Diabetes 2016 Updates

Self-Care Sunday: Standards of Medical Care in Diabetes 2016 Updates Each year, the American Diabetes Association (ADA) provides an updated version to their standards of care for health care practitioners. One of the biggest changes is that the ADA is moving away from the term diabetic when describing people with diabetes. Instead, they are recommending that everyone refer to these patients as individuals with diabetes. As someone with Type 1 diabetes, it has always been a pet peeve of mine when someone defines themselves or a loved one with the term diabetic. There is much more to a person than the disease/condition that they live with! Similarly to someone struggling with an eating disorder, one would prefer not to be called a bulimic or anorexic, but rather someone with the condition. Diabetes does not define the person and it is relieving to see that the ADA recognizes this. The original Standards of Care are over 100 pages, but the ADA has put out a summary of revisions that I have outlined below to discuss the specific section changes: Section 1. Strategies for Improving Care: This section now includes recommendations on tailoring treatment to vulnerable populations such as those with food insecurities, mental illness, HIV, etc. Section 2. Classification and Diagnosis of Diabetes: The ADA has revised their screening recommendations to test all adults beginning at age 45 years, regardless of weight/history. Testing is now recommended also for all adults who are considered overweight/obese and who may have one or more additional risk factors of diabetes. Section 3. Foundations of Care and Comprehensive Medical Evaluation: Two sections from the prior 2015 Standards were combined to create this section, which now encompasses medical evaluation, patient engagement, an Continue reading >>

Abnormal Blood Glucose And Type 2 Diabetes Mellitus: Screening

Abnormal Blood Glucose And Type 2 Diabetes Mellitus: Screening

Population Recommendation Grade (What's This?) Adults aged 40 to 70 years who are overweight or obese The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to promote a healthful diet and physical activity. B This recommendation applies to adults aged 40 to 70 years who are seen in primary care settings and do not have obvious symptoms of diabetes. Persons who have a family history of diabetes, have a history of gestational diabetes or polycystic ovarian syndrome, or are members of certain racial/ethnic groups (that is, African Americans, American Indians or Alaskan Natives, Asian Americans, Hispanics or Latinos, or Native Hawaiians or Pacific Islanders) may be at increased risk for diabetes at a younger age or at a lower body mass index. Clinicians should consider screening earlier in persons with 1 or more of these characteristics. Continue reading >>

Exercise Recommendations For Patients With Type 2 Diabetes

Exercise Recommendations For Patients With Type 2 Diabetes

Exercise recommendations for patients with type 2 diabetes Journal of the American Academy of Physician Assistants: January 2016 - Volume 29 - Issue 1 - p 1318 ABSTRACTThe American College of Sports Medicine and American Diabetes Association recommend that patients with type 2 diabetes participate in at least 150 minutes of moderate exercise weekly with resistance training two or three times weekly. This article reviews the guidelines, preparticipation cardiovascular screening recommendations, and considerations for patients with diabetes and comorbidities who are planning to participate in regular exercise regimens. Joy A. Dugan is an adjunct assistant professor in the joint master of physician assistant studies/master of public health program at Touro University in Vallejo, Calif. The author has disclosed no potential conflicts of interest, financial or otherwise. Earn Category I CME Credit by reading both CME articles in this issue, reviewing the post-test, then taking the online test at . Successful completion is defined as a cumulative score of at least 70% correct. This material has been reviewed and is approved for 1 hour of clinical Category I (Preapproved) CME credit by the AAPA. The term of approval is for 1 year from the publication date of January 2016. For patients with type 2 diabetes, exercise improves blood glucose control and reduces the risk of comorbidities including hyperlipidemia, hypertension, and ischemic heart disease. 1 According to the CDC, more than 29 million Americans (about 9% of the population) have type 2 diabetes and most are not physically active. 2,3 A joint position statement by the American College of Sports Medicine (ACSM) and American Diabetes Association (ADA) recommends at least 150 total minutes of moderate-intensity aerobic ac Continue reading >>

Standards Of Medical Care In Diabetes2016 Abridged For Primary Care Providers

Standards Of Medical Care In Diabetes2016 Abridged For Primary Care Providers

Standards of Medical Care in Diabetes2016 Abridged for Primary Care Providers We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Standards of Medical Care in Diabetes2016 Abridged for Primary Care Providers The American Diabetes Associations (ADAs) Standards of Medical Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes Care. Formerly called Clinical Practice Recommendations, the Standards includes the most current evidence-based recommendations for diagnosing and treating adults and children with all forms of diabetes. ADAs grading system uses A, B, C, or E to show the evidence level that supports each recommendation. AClear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered BSupportive evidence from well-conducted cohort studies CSupportive evidence from poorly controlled or uncontrolled studies EExpert consensus or clinical experience This is an abridged version of the current Standards containing the evidence-based recommendations most pertinent to primary care. The tables and figures have been renumbered from the original document to match this version. The complete 2016 Standards of Care document, including all supporting references, is available at professional.diabetes.org/standards. A patient-centered communication style that incorporates patient preferences, assesses literacy and numeracy, and addresses cultural barriers to c Continue reading >>

Indian Research Society For The Study Of Diabetes In India (rssdi) Recommendations For Diabetes Management: A Psychosocial Commentary Kalra S, Bajaj S, Das Ak - J Soc Health Diabetes

Indian Research Society For The Study Of Diabetes In India (rssdi) Recommendations For Diabetes Management: A Psychosocial Commentary Kalra S, Bajaj S, Das Ak - J Soc Health Diabetes

Kalra S, Bajaj S, Das AK. Indian Research Society for the Study of Diabetes in India (RSSDI) recommendations for diabetes management: A psychosocial commentary. J Soc Health Diabetes 2016;4:1-2 Kalra S, Bajaj S, Das AK. Indian Research Society for the Study of Diabetes in India (RSSDI) recommendations for diabetes management: A psychosocial commentary. J Soc Health Diabetes [serial online] 2016 [cited2018 Apr 2];4:1-2. Available from: The Research Society for the Study of Diabetes in India (RSSDI) recently released comprehensive clinical practice recommendations for the management of type 2 diabetes mellitus (T2DM). [1] The published document is a "derived guideline," developed from the International Diabetes Federation (IDF) Global Guideline for type 2 Diabetes. [2] The authors of the RSSDI recommendations have fulfilled a major felt need for the Indian diabetes care community by providing practical and pragmatic guidance that is relevant for and suited to the Indian content. In this editorial, we focus on the aspects of diabetes care specific to India, covered in the RSSDI document, and discuss how maximal utility can be gained from the coverage of these topics. The Indian recommendations are structured into 20 sections, including the preface and annexure, while most of the contents are similar to the recommended care and limited care versions of the IDF guidelines, some sections merit special attention because of their novel suggestions. These include prediabetes, diet therapy, lifestyle management, targets of glucose control, footcare, fasting, and diabetes. RSSDI has included detailed coverage of prediabetes in its diabetes management recommendations. This has been done keeping in mind the high prevalence of this condition in India. [3] The diagnostic cutoffs and Continue reading >>

Search Results

Search Results

Committee has been involved in shaping guidance from external organisations, most notably the NICE documents on 'Intrapartum care' and 'Diabetes in pregnancy', and a current FIGO initiative for gestational diabetes ... and resources.NCC-WCH Consortium Board The Centres relocation to the RCOG has brought some challenges but this has not prevented major achievements during 2014/15. These have included the publication of the following major guidelines Macrosomia detected in 3rd trimester (query bank) the evidence bysubmitting a new Clinical Query.The NICE diabetes in pregnancy guideline describes the evidence for risk factors for gestational ... diabetes in para 4.2 of the full guideline: An RCT conducted in the USA (Griffin) compared a risk factor-based screening programme for gestational diabetes the evidence by submitting a new clinical query.Only one study reporting outcomes at increasing gestational ... age in women with uncomplicated polyhydramnios was identified. Pilliod et al found that the risk of intrauterine fetal death (IUFD) in pregnancies affected by polyhydramnios was greater at every gestational Continue reading >>

Ada Diabetes Management Guidelines A1c Diagnosis | Ndei

Ada Diabetes Management Guidelines A1c Diagnosis | Ndei

Criteria for Diabetes Diagnosis: 4 options Fasting is defined as no caloric intake for 8 hours 2-hr PG 200 mg/dL (11.1 mmol/L) during OGTT (75-g)* Using a glucose load containing the equivalent of 75g anhydrous glucose dissolved in water Performed in a lab using NGSP-certified method and standardized to DCCT assay In individuals with symptoms of hyperglycemia or hyperglycemic crisis No clear clinical diagnosis? Immediately repeat the same test using a new blood sample. Same test with same or similar results? Diagnosis confirmed. Different tests above diagnostic threshold? Diagnosis confirmed. Discordant results from two separate tests? Repeat the test with a result above diagnostic cut-point. Conditions associated with insulin resistance *African-American, Latino, Native American, Asian American, Pacific Islander Severe obesity, acanthosis nigricans, polycystic ovarian syndrome Screening Children for Type 2 Diabetes and Prediabetes Consider screening for type 2 diabetes and prediabetes for all children who are overweight* and have two or more of the following risk factors: Family history of type 2 diabetes in a first- or second-degree relative Native American, African American, Latino, Asian American, or Pacific Islander descent Signs of insulin resistance or conditions associated with insulin resistance Maternal history of diabetes or GDM during the childs gestation Test every 3 years using A1C beginning at age 10 or onset of puberty *BMI >85th percentile for age and sex, weight for height >85th percentile, or weight >120% ideal weight Acanthosis nigricans, hypertension, dyslipidemia, polycystic ovarian syndrome, or small-for-gestational-age birth weight Screening for Gestational Diabetes (GDM) Test for undiagnosed type 2 at first prenatal visit using standard diagnos Continue reading >>

Diabetes Mellitus: Screening And Diagnosis

Diabetes Mellitus: Screening And Diagnosis

Diabetes mellitus is one of the most common diagnoses made by family physicians. Uncontrolled diabetes can lead to blindness, limb amputation, kidney failure, and vascular and heart disease. Screening patients before signs and symptoms develop leads to earlier diagnosis and treatment, but may not reduce rates of end-organ damage. Randomized trials show that screening for type 2 diabetes does not reduce mortality after 10 years, although some data suggest mortality benefits after 23 to 30 years. Lifestyle and pharmacologic interventions decrease progression to diabetes in patients with impaired fasting glucose or impaired glucose tolerance. Screening for type 1 diabetes is not recommended. The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose and type 2 diabetes in adults 40 to 70 years of age who are overweight or obese, and repeating testing every three years if results are normal. Individuals at higher risk should be considered for earlier and more frequent screening. The American Diabetes Association recommends screening for type 2 diabetes annually in patients 45 years and older, or in patients younger than 45 years with major risk factors. The diagnosis can be made with a fasting plasma glucose level of 126 mg per dL or greater; an A1C level of 6.5% or greater; a random plasma glucose level of 200 mg per dL or greater; or a 75-g two-hour oral glucose tolerance test with a plasma glucose level of 200 mg per dL or greater. Results should be confirmed with repeat testing on a subsequent day; however, a single random plasma glucose level of 200 mg per dL or greater with typical signs and symptoms of hyperglycemia likely indicates diabetes. Additional testing to determine the etiology of diabetes is not routinely recommended. Clinical r Continue reading >>

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