Updated evidence for diabetes care, including guidelines for self-monitoring glucose, new blood pressure targets, and other aspects of care, are presented in a major position statement from the American Diabetes Association (ADA), “Standards of Medical Care in Diabetes,” published as a supplement to Diabetes Care.
Researchers from the ADA reviewed current scientific literature and updated the Association’s Standards of Medical Care in Diabetes for 2013.
The report updates several aspects of diabetes care, including more specific recommendations for diabetes screening, management of dyslipidemia, nephropathy and retinopathy screening, and medical nutrition therapy, as well as newly revised standards for self-management education and support. Detailed guidelines are presented for glucose monitoring to clarify how often and when patients should do self-monitoring of blood glucose; this is recommended at least before meals and snacks, occasionally postprandially, before exercise, at bedtime, on suspicion of low blood glucose and through treatment until reaching normoglycemia, and before critical tasks such as driving. Systolic blood pressure goals have been updated to reflect new evidence, and those with diabetes should be treated to a systolic blood pressure goal of less than 140 mm Hg and diastolic blood pressure of less than 80 mm Hg, with lower systolic targets recommended for certain individuals such as younger patients.
“ADA will continue to improve and update the Clinical Practice Recommendations to ensure that clinicians, health plans, and policymakers can continue to rely on them as the most authoritative and current guidelines for diabetes care,” the authors write.