In 2018, the American Diabetes Association (ADA) has issued updates for their Standards of Care and will provide periodic revisions and online updates throughout the year. The intent of the ADA is to ensure that the Standards of Care will provide clinicians, patients, researchers, health plans, and policymakers with up-to-date information on diabetes care, general treatments, and tools to evaluate the quality of care. While this course will concentrate on the ADA’s criteria for diabetes diagnosis, key changes and revisions of the 2018 ADA guidelines will also be described.
The following is a summary of the key changes and revisions in the 2018 ADA Guideline:
- Cardiovascular disease (CVD) risk management advice includes hypertension management: Based upon the results of multiple cardiovascular outcome trials (CVOT), the ADA has issued new treatment recommendations for adults with type 2 diabetes after lifestyle management and metformin use to include medications to improve heart health. In addition, the ADA recommendation indicates that all hypertensive patients with diabetes monitor their blood pressure at home to help identify potential discrepancies between office vs. home blood pressure, and to improve medication-taking behavior. Targeted blood pressure readings are included in the updated ADA recommendations.
- Screening youth for type 2 diabetes: Updated recommendations emphasize that testing for prediabetes and type 2 diabetes should be considered in children and adolescents younger than 18 years of age who are overweight or obese and have one or more additional risk factors for diabetes. (More details are presented in the ADA guidelines relative to criteria for overweight and obesity and lists of risk factors for diabetes).