Release of ADA 2018 Standards with new recommendations for diabetes patients with CVD
The ADA Standards of Medical Care in Diabetes provide clinicians, patients, researchers, health plans and policymakers with the most up-to-date insights on diabetes care, general treatment goals and tools to evaluate the quality of care. Important changes and updates in the 2018 edition include:
- Based upon the results of multiple cardiovascular outcome trials, there are new treatment recommendations for type 2 diabetes patients with CVD, including hypertension. The results of randomized controlled trials support the ADA’s recommendation that most adults with hypertension should have a target blood pressure <140/90 mmHg and lower targets may be appropriate for some patients; a new algorithm illustrates the recommended antihypertensive treatment approach in patients with type 2 diabetes. In addition, it is recommended that all hypertensive patients with diabetes should monitor their blood pressure at home.
- Routine screening for prediabetes and type 2 diabetes should be considered in children and adolescents younger than 18 years of age who are at high risk (BMI >85th percentile plus at least one additional risk factor).
- Recommendations are provided for integration of new technology into diabetes management for effective self-management education and support and for continuous glucose monitoring (CGM).
- Additional language and recommendations have been added to help ensure appropriate use of the HbA1C test to diagnose diabetes and to monitor glycemic control in people with diabetes.
- Recommendations for diabetes management in specific subgroups, such as older adults and pregnant women with preexisting type 1 or 2 diabetes, were added.
- Drug-specific and patient factors that may impact treatment were summarized and recommendations for increased awareness of and screening for social determinants of health were made.