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American Diabetes Association Ada Clinical Practice Recommendations

Review Of The Ada Standards Of Medical Care In Diabetes 2018 | Annals Of Internal Medicine | American College Of Physicians

Review Of The Ada Standards Of Medical Care In Diabetes 2018 | Annals Of Internal Medicine | American College Of Physicians

Author, Article, and Disclosure Information This article was published at Annals.org on 3 April 2018. St. Mark's Hospital and St. Mark's Diabetes Center, Salt Lake City, Utah (J.J.C.) UND School of Medicine and Health Sciences, Grand Forks, North Dakota (E.L.J.) Touro University College of Osteopathic Medicine, Vallejo, California (J.H.S.) Utah State University, Taylorsville, Utah (L.P.) Acknowledgment: The authors thank Sarah Bradley; Matt Petersen; and Erika Gebel Berg, PhD, for their invaluable assistance in the reviewing and editing of this manuscript. The full Standards of Medical Care in Diabetes2018 was developed by the ADA's Professional Practice Committee: Rita R. Kalyani, MD, MHS (Chair); Christopher Cannon, MD; Andrea L. Cherrington, MD, MPH; Donald R. Coustan, MD; Ian de Boer, MD, MS; Hope Feldman, CRNP, FNP-BC; Judith Fradkin, MD; David Maahs, MD, PhD; Melinda Maryniuk, Med, RD, CDE; Medha N. Munshi, MD; Joshua J. Neumiller, PharmD, CDE; and Guillermo E. Umpierrez. ADA staff support includes Erika Gebel Berg, PhD; Tamara Darsow, PhD; Matt Petersen; Sacha Uelmen, RDN, CDE; and William T. Cefalu, MD. Disclosures: Dr. Chamberlain reports other support from Novo Nordisk, Sanofi Aventis, Janssen, and Merck outside the submitted work. Dr. Johnson reports personal fees from Novo Nordisk, Medtronic, and Sanofi outside the submitted work. Dr. Rhinehart reports employment with and stock ownership in Glytec. Dr. Shubrook reports personal fees from Novo Nordisk, Lilly Diabetes, and Intarcia outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0222 . Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that he Continue reading >>

American Diabetes Associations New Clinical Practice Recommendations Promote A1c As Diagnostic Test For Diabetes And Pre-diabetes

American Diabetes Associations New Clinical Practice Recommendations Promote A1c As Diagnostic Test For Diabetes And Pre-diabetes

Faster, easier test could help reduce number of undiagnosed with diabetes and pre-diabetes. The American Diabetes Associations (ADA) new Clinical Practice Recommendations being published as a supplement to the January issue of Diabetes Care call for the addition of the A1c test as a means of diagnosing diabetes and identifying pre-diabetes. The test has been recommended for years as a measure of how well people are doing to keep their blood glucose levels under control. "We believe that use of the A1c, because it doesnt require fasting, will encourage more people to get tested for Type 2 diabetes and help further reduce the number of people who are undiagnosed but living with this chronic and potentially life-threatening disease. Additionally, early detection can make an enormous difference in a persons quality of life," said Richard M. Bergenstal, MD, President-Elect, Medicine & Science, ADA. "Unlike many chronic diseases, Type 2 diabetes actually can be prevented, as long as lifestyle changes are made while blood glucose levels are still in the pre-diabetes range." A1c is measured in terms of percentages. The test measures a persons average blood glucose levels over a period of up to three months and previously had been used only to determine how well people were maintaining control of their diabetes over time. A person without diabetes would have an A1c of about 5 percent. Under the new recommendations, which are revised every year to reflect the most current available scientific research, an A1c of 5.7 6.4 percent would indicate that blood glucose levels were in the pre-diabetic range, meaning higher than normal but not yet high enough for a diagnosis of diabetes. That diagnosis would occur once levels rose to an A1c of 6.5 percent or higher. The ADA recommends tha Continue reading >>

Clinical Practice Guidelines

Clinical Practice Guidelines

Clinical practice guidelines are the strongest resources to aid dental professionals in clinicaldecision making and help incorporate evidence gained through scientificinvestigation into patient care. Guidelines include recommendation statements intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Evidence-Based Clinical Practice Guideline for the Evaluation of Potentially Malignant Disorders in the Oral Cavity A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents an evidence-based clinical practice guideline on evaluating patients for oral cancer. The goal of this 2017 clinical practice guideline is to inform clinicians about the potential use of adjuncts as triage tools for the evaluation of lesions, including potentially malignant disorders (PMDs), in the oral cavity. View Fluoride Toothpaste for Young Children Guideline Now The American Dental Association (ADA) Council on Scientific Affairs met with stakeholders to discuss differing public messaging on the use of fluoride toothpaste for young children. The participants agreed that a unified recommendation on the use of fluoride toothpaste for young children would be preferable and less confusing to the public. View Nonsurgical Treatment of Chronic Periodontitis Guideline Now A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents an evidence-based clinical practice guideline and systematic review on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. View Infective Endocarditis Guideline Now The guidelines update the 1997 recommen Continue reading >>

American Diabetes Association Revises Diabetes Guidelines

American Diabetes Association Revises Diabetes Guidelines

American Diabetes Association Revises Diabetes Guidelines December 29, 2009 The American Diabetes Association (ADA) revised clinical practice recommendations for diabetes diagnosis promote hemoglobin A1c (A1c) as a faster, easier diagnostic test that could help reduce the number of undiagnosed patients and better identify patients with prediabetes. The new recommendations are published December 29 in the January supplement of Diabetes Care. "We believe that use of the A1c, because it doesn't require fasting, will encourage more people to get tested for type 2 diabetes and help further reduce the number of people who are undiagnosed but living with this chronic and potentially life-threatening disease," Richard M. Bergenstal, MD, ADA president-elect of medicine & science, said in a news release. "Additionally, early detection can make an enormous difference in a person's quality of life. Unlike many chronic diseases, type 2 diabetes actually can be prevented, as long as lifestyle changes are made while blood glucose levels are still in the pre-diabetes range." The A1c test, which measures average blood glucose levels for a period of up to 3 months, was previously used only to evaluate diabetic control with time. An A1c level of approximately 5% indicates the absence of diabetes, and according to the revised evidence-based guidelines, an A1c score of 5.7% to 6.4% indicates prediabetes, and an A1c level of 6.5% or higher indicates the presence of diabetes. For optimal diabetic control, the recommended ADA target for most people with diabetes is an A1c level no greater than 7%. It is hoped that achieving this target would help prevent serious diabetes-related complications including nephropathy, neuropathy, retinopathy, and gum disease. Unlike fasting plasma glucose testin Continue reading >>

Clinical Use

Clinical Use

Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals. From the Executive Summary of the 2014 American Diabetes Association Clinical Practice Recommendations (Diabetes Care 2014;37,suppl.1:S5-13) Consider A1C targets as close to non-diabetic levels (< 6.5 percent) as possible without significant hypoglycemia in people with short duration of diabetes, little comorbidity, and long life expectancy. Consider less stringent A1C targets (e.g., 8 percent) for people with a history of severe hypoglycemia, limited life expectancy, extensive comorbid conditions, advanced complications, major impairments to self-management (e.g., visual, cognitive, social), or long-standing diabetes where the A1C goal is difficult to attain despite optimal efforts. Reassess A1C targets and change (lower or higher) as appropriate. From: National Diabetes Education Program website on Guiding Principles, When interpreting laboratory results health care providers should: be informed about the A1C assay methods used by their laboratory send blood samples for diagnosis to a laboratory that uses an NGSP-certified method for A1C analysis to ensure the results are standardized consider the possibility of interference in the A1C test when a result is above 15% or is at odds with other diabetes test results consider each patient’s profile, including risk factors and history, and individualize diagnosis and treatment decisions in discussion with the patient From: National Diabetes Information Clearinghouse (NDIC), Links to clinical guidelines from other organizations are listed below; the NGSP does not endorse specific guideli 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 >>

Openclinical Applications: Ada Clinical Practice Recommendations For Diabetes Care For Palm Os

Openclinical Applications: Ada Clinical Practice Recommendations For Diabetes Care For Palm Os

ADA Clinical Practice Recommendations for diabetes care for Palm and Pocket PC Comprehensive summary of the American Diabetes Association Standards of Care for the diagnosis, management and treatment of diabetes. " The American Diabetes Association (ADA) has been actively involved in the development and dissemination of diabetes care standards, guidelines, and related documents for many years. These statements are published in one or more of the Association's professional journals. This supplement contains the latest update of ADA's major position statement, Standards of Medical Care in Diabetes, which contains all of the Association's key recommendations. In addition, contained herein are selected position statements on certain topics not adequately covered in the Standards. ADA hopes that this is a convenient and important resource for all health care professionals who care for people with diabetes. ADA Clinical Practice Recommendations consist of position statements that represent official ADA opinion as denoted by formal review and approval by the Professional Practice Committee and the Executive Committee of the Board of Directors. Consensus statements and technical reviews are not official ADA recommendations; however, they are produced under the auspices of the Association by invited experts. These publications may be used by the Professional Practice Committee as source documents to update the Standards. " Continue reading >>

Hospital Guidelines For Diabetes Management And The Joint Commission-american Diabetes Association Inpatient Diabetes Certification☆

Hospital Guidelines For Diabetes Management And The Joint Commission-american Diabetes Association Inpatient Diabetes Certification☆

Jump to Section Abstract Background The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association’s Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. Methods The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. Results The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. Conclusions The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Continue reading >>

Basic Guidelines For Diabetes Care

Basic Guidelines For Diabetes Care

Benefits/Harms of Implementing the Guideline Recommendations Appropriate management and education of patients with type 2 diabetes Rating Scheme for the Strength of the Recommendations These Guidelines are intended for use by primary care professionals to diagnose, manage and educate patients with type 2 diabetes. While providing recommendations the Guidelines are not intended as a substitute for the advice of a physician or other health care professional. These Guidelines are updated every two years or as significant changes or recommendations are identified. Methods Used to Collect/Select the Evidence Hand-searches of Published Literature (Primary Sources) Hand-searches of Published Literature (Secondary Sources) Description of Methods Used to Collect/Select the Evidence Pertinent articles for review were identified from the current American Diabetes Association (ADA) Clinical Practice Recommendations, Medline searches and the reference list from the previous year's Basic Guidelines for Diabetes Care. The time frame of the literature search was 2009 to 2012. Some references of "gold standard" trials are older. The specific search terms differed based on which subsection of the guidelines was being reviewed. The article list for each guideline was then reviewed for completeness. Articles from older or lower-rated studies were removed from the list if a more current, higher quality study on the list contributed the same or new information. Methods Used to Assess the Quality and Strength of the Evidence Weighting According to a Rating Scheme (Scheme Given) Rating Scheme for the Strength of the Evidence Experts in diabetes care reviewed and rated the body of evidence using a system adopted from the American Diabetes Association (ADA) grading system for clinical practice Continue reading >>

Ada Updates Standards Of Medical Care For Patients With Diabetes Mellitus

Ada Updates Standards Of Medical Care For Patients With Diabetes Mellitus

Key Points for Practice • All adults should be tested for diabetes beginning at 45 years of age. • Overweight or obese patients with one or more risk factors for diabetes should be screened at any age. • Persons who use continuous glucose monitoring and insulin pumps should have continued access after 65 years of age. • Aspirin therapy should be considered for women with diabetes who are 50 years and older. • The addition of ezetimibe to statin therapy should be considered for eligible patients who can tolerate only a moderate-dose statin Ongoing patient self-management education and support are critical to preventing acute complications of diabetes mellitus and reducing the risk of long-term complications. The American Diabetes Association (ADA) recently updated its standards of care to provide the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Key changes in the 2016 update include new screening recommendations, clarification of diagnostic testing, and recommendations on the use of new technology for diabetes prevention, the use of continuous glucose monitoring devices, cardiovascular risk management, and screening for hyperlipidemia in children with type 1 diabetes. General recommendations for treatment of type 2 diabetes are shown in Figure 1. Antihyperglycemic therapy in type 2 diabetes: general recommendations. The order in the chart was determined by historical availability and the route of administration, with injectables to the right; it is not meant to denote any specific preference. Potential sequences of antihyperglycemic therapy for patients with type 2 diabetes are displayed, with the usual transition moving vertically from top to bottom, although horizontal movement within therapy stages is also Continue reading >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>

Altmetric 9. Cardiovascular Disease And Risk Management: Standards Of Medical Care In Diabetes2018

Altmetric 9. Cardiovascular Disease And Risk Management: Standards Of Medical Care In Diabetes2018

Outputs of similar age from Diabetes Care Altmetric has tracked 9,729,720 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric. So far Altmetric has tracked 6,301 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.4. This one has done particularly well, scoring higher than 91% of its peers. Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 275,595 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries. We're also able to compare this research output to 122 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries. 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 >>

Adas 2018 Standards Of Medical Care Released

Adas 2018 Standards Of Medical Care Released

ADAs 2018 Standards of Medical Care Released Every year the American Diabetes Association (ADA) puts out an updated Standards of Medical Care approved by their board of directors which is their official position and provides all of their current clinical practice recommendations. In this years Standards they state that To update the Standards of Care, the ADAs Professional Practice Committee (PPC) performs an extensive clinical diabetes literature search, supplemented with input from ADA staff and the medical community at large. they update it each year or as needed online based on incoming evidence or regulatory changes. It should be noted that most current Standards supersedes all previous ADA position statements. Citing the way the field of diabetes moves quickly, the 2018 Standards of Care reveals the following major revisions: Limits of A1c and Diagnostic Recommendations Since recent evidence shows limits to A1c measurements because of hemoglobin variants among individuals, conditions that affect red blood cell turnover, and assay interference, recommendations have been added to clarify the appropriate use of the A1C test generally and in the diagnosis of diabetes in these special cases, states the ADA . The ADA now recommends pre-diabetes and type 2 diabetes screening in children and teens who are overweight or obese and have one or more additional risk factors. Comprehensive Medical Evaluation and Comorbidities Components of a comprehensive medical evaluation now includes information about the recommended frequency of the components of care at both initial and follow-up visits. The ADA added information about the importance of language choice in patient-centered communication. They also now recommend healthcare providers consider checking serum testosterone leve Continue reading >>

Idf Clinical Practice Recommendations For Managing Type 2 Diabetes In Primary Care

Idf Clinical Practice Recommendations For Managing Type 2 Diabetes In Primary Care

IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care - 2017 2 IDF Working Group Chair: Pablo Aschner, MD,MSc, Javeriana University and San Ignacio University Hospital, Bogota, Colombia. Core Contributors: Amanda Adler, MD, PhD, FRCP, Addenbrooke´s Hospital and National Institute for Health and Care Excellence(NICE), Cambridge, UK Cliff Bailey, PhD, FRCP(Edin), FRCPath, Aston University, Birmingham,UK Juliana CN Chan, MB ChB, MD, MRCP (UK), FRCP (Lond), FRCP (Edin), FRCP (Glasgow), FHKAM (Medicine), Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong, China. Stephen Colagiuri, MB, BS Honours Class II, FRACP, The Boden Institute, University of Sydney, Sydney, Australia Caroline Day, PhD, FRSB, MedEd UK and Aston University, Birmingham, UK Juan Jose Gagliardino, MD, Cenexa (Unlp-Conicet), La Plata, Argentina Lawrence A. Leiter, MD, FRCPC, FACP, FACE, FAHA, Clinical Nutrition and Risk Factor Modification Centre, Li Ka Shing Knowledge Institute at St. Michael’s Hospital and University of Toronto, Toronto, Canada Shaukat Sadikot, MD, President International Diabetes Federation (2016-2017), Diabetes India and Jaslok Hospital, Mumbai, India Nam Han Cho, MD, PhD, President-Elect International Diabetes Federation (2016-17), Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea Eugene Sobngwi, MD, MPhil, PhD, Central Hospital and University of Yaounde, Yaounde, Cameroon Acknowledgements Milena Garcia, MD, MSc, Javeriana University and San Ignacio University Hospital, Bogota, Colombia. Co-chaired the consensus meeting and contributed to the appraisal of the guidelines Chris Parkin - Medical writing support, CGParkin Communications, USA Martine V Continue reading >>

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