The American Diabetes Association 2019 Standards of Medical Care in Diabetes includes several new and revised clinical practice recommendations designed to put the patient at the center of care, including efforts to reduce therapeutic inertia, utilize person-centered language and expanded recommendations for children and adolescents with type 2 diabetes.
The updated standards, published online in Diabetes Care Monday, also reflect a collaboration between the American College of Cardiology and the American Heart Association to align goals for optimal CVD management. For the first time this year, the updated ADA standards are endorsed by the ACC.
“The new 2019 Standards of Care emphasize a patient-centered approach that considers the multiple health and life factors of each person living with diabetes,” William T. Cefalu, MD, chief scientific, medical and mission officer for the ADA, said in a press release. “We are also pleased about our close collaboration with the American College of Cardiology, aligning the ADA’s CVD recommendations with the ACC for the first time ever, and also complements our new Know Diabetes by Heart initiative with the American Heart Association. These updated CVD guidelines can help to significantly reduce mortality from CVD, the leading cause of death in people living with diabetes.”
This year’s standards include the following updates:
- A new Goals of Care graphic decision cycle, detailing the need for shared decision-making between patient and provider to help reduce therapeutic inertia and improve patient self-management;
- New text on the use of appropriate language to communicate about diabetes with patients and professional audiences in an “informative, empowering and educational style;”
- New recommendations on lifestyle management, including the nutritional and physical activity needs for older adults;
- A new treatment algorithm to simplify insulin therapy, plus a new table to guide providers in simplifying or deprescribing pharmacotherapy for older adults; and
- New guidance for the management of new-onset diabetes in youths with overweight or obesity.
The 2019 standards reflect an effort by the ADA that began in 2018 to revise the guide throughout the year, rather than annually, as new evidence or regulatory changes merit immediate incorporation.
In November, the ADA and AHA launched a joint, multiyear partnership to raise awareness about the increased risk for CVD among those living with type 2 diabetes. As Endocrine Today previously reported, the Know Diabetes by Heart initiative includes a website, www.KnowDiabetesByHeart.org, with resources for those with type 2 diabetes, including education materials on the increased risk for CVD. The site also includes a risk awareness quiz and a discussion guide with “conversation starters” for patients’ next appointment with their health care provider.
Additionally, in an updated joint consensus report released in October and reported by Endocrine Today, the ADA and the European Association for the Study of Diabetes said providers should prioritize patient-centered care for type 2 diabetes that incorporates therapy regimens tailored to specific patient goals, whereas new medications shown to reduce CV risk should be introduced earlier for high-risk patients.
“The 2019 Standards of Care affirm the ADA’s commitment to providing rapid release of evidence-based recommendations that can yield improved patient outcomes and reduce complications and health care costs, and we hope providers will continue to download and use the mobile app for easy access to the Standards of Care at the point of care.” – by Regina Schaffer
For more information:
ADA 2019 Standards of Care. Available at: http://care.diabetesjournals.org/content/42/Supplement_1. Accessed: Dec. 17, 2018.
Disclosures: Cefalu is chief scientific, medical and mission officer for the ADA. Please see the 2019 Standards of Care for the authors’ relevant financial disclosures.