Monday, March 8, 2010

Revisions to the 2010 “Standards of Medical Care in Diabetes”

I was speaking with a physician the other day about the Revisions to the “Standards of Medical Care in Diabetes” published in January 2010 by the American Diabetes Association in Diabetes Care. Do you know what those revisions include?

Revisions to the “Standards of Medical Care in Diabetes”

In addition to many small changes related to new evidence since the previous version, the following sections have undergone major changes:
  • The section “Diagnosis of diabetes” has been revised to include the use of A1C to diagnose diabetes, with a cut point of ≥6.5%.
  • The section previously titled “Diagnosis of pre-diabetes” has been renamed “Categories of increased risk for diabetes.” In addition to impaired fasting glucose and impaired glucose tolerance, an A1C range of 5.7–6.4% has been included as a category of increased risk for future diabetes.
  • The section “Detection and diagnosis of GDM” has been revised to discuss potential future changes in the diagnosis based on international consensus.
  • The section “Diabetes self-management education” has been extensively revised to reflect new evidence.
  • The section “Antiplatelet agents” has been extensively revised to reflect recent trials questioning the benefit of aspirin for primary cardiovascular disease prevention in moderate- or low-risk patients. The recommendation has changed to consider aspirin therapy as a primary prevention strategy in those with diabetes at increased cardiovascular risk (10-year risk >10%). This includes men >50 years of age or women >60 years of age with at least one additional major risk factor.
  • The section “Retinopathy screening and treatment” has been updated to include a recommendation on use of fundus photography as a screening strategy.
  • The section “Diabetes care in the hospital” has been extensively revised to reflect new evidence calling into question very tight glycemic control goals in critically ill patients.
  • The section “Strategies for improving diabetes care” has been extensively revised to reflect newer evidence.
Click here to view the summary published in Diabetes Care.

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