Diabetes and Notable Updates to the American Diabetes Association (ADA) Standards of Care in Diabetes ─ 2023 Guidelines

Diabetes | American Diabetes Association (ADA) Guidelines | Notable Updates to the American Diabetes Association (ADA) Guidelines 

Nick Jonas

“Diabetes sounds like you’re going to die when you hear it. I was immediately frightened. But once I got a better idea of what it was and that is was something I could manage myself, I was comforted.”

Introduction

Diabetes is a complex and chronic illness require continuous medical. Diabetes Mellitus (DM) is a multi-factorial chronic health condition that affects a large part of population. Additionally, it is a significant risk factor for cardiovascular diseases, which increases its morbidity and mortality. Diabetes is one of the major global health burdens in the twenty-first century, among which type 2 diabetes mellitus is the most prevalent form of diabetes. 

Evidence-based recommendations drive better care for all people with diabetes, including people who are at high risk and vulnerable communities. American Diabetes Association (ADA) Standards of Care are the gold standard for diabetes care and prevention that allows clinicians around the world to remain abreast of the rapidly changing healthcare landscape. 

Main Symptoms of Diabetes   

Major Risk Factors of Diabetes  

The major factors of the global type 2 diabetes mellitus (T2DM) epidemic include
·     An ageing population
·     Lack of exercise
·     Overweight and obesity
·     Sedentary lifestyle
·     Increased consumption of unhealthy diets and sugar-sweetened beverages. 

 

Notable Updates to the Standards of Care in Diabetes─2023

Diabetes care is rapidly evolving as innovative research, new technology, and treatments improve the health and well-being of people with diabetes continues to emerge. 

The American Diabetes Association^® (ADA) every year publishes comprehensive, evidence-based guidelines called “Standards of Care in Diabetes” for the prevention, diagnosis, and treatment of diabetes. Based on the most recent scientific research work and various clinical trials, the Standards of Care includes essential new and rationalized practice guidelines to care for people with diabetes.

 

Importance on supporting higher weight loss (up to 15%)	New recommendations related to sleep health and physical activity
New hypertension diagnosis cut-offs  - Systolic blood pressure ≥130 mmHg or - Diastolic blood pressure ≥80 mmHg	New lipid management recommendations  - Suggesting lower LDL targets for high-risk individuals
Expanded role of SGLT2 inhibitor for example: canagliflozin, dapagliflozin, and empagliflozin) use in preserved and reduced heart failure ejection fraction	Role of finerenone (a nonsteroidal, selective mineralocorticoid receptor antagonist) in individuals with - Diabetes - Chronic kidney disease with albuminuria
An expanded “Nonalcoholic Fatty Liver Disease” (NAFLD) subsection	The utility of point-of-care A1C testing for diabetes screening and diagnosis
Details on digital health, telehealth, and telemedicine and the benefits of these modalities of care delivery	The use of technology in older adults with diabetes

·         Updates are in alignment with the Management of Hyperglycemia in Type 2 Diabetes

 
·       The use of person-first and inclusive language
“People First Language” (PFL) uses phrases such as “person with a disability,” “individuals with disabilities,” and “children with disabilities,” as opposed to phrases that identify people based solely on their disability, such as “the disabled.” People First Language” (PFL) puts the person before the disability, and describes what a person has, not who a person is.
 
·    Updates in vaccination for people with diabetes: bivalent COVID-19 booster, COVID-19 and pneumococcal pneumonia vaccinations. 
 
·  Updates in COVID-19 and diabetes: Information included on the use of continuous glucose monitoring (CGM) in the inpatient setting during the COVID-19 pandemic.

Additional Reads:

Telehealth

Telehealth is a growing field that may enhance care for people with diabetes.
 

Digiceuticals or Digital Health Technology

The regulatory agencies like FDA approves and monitors clinically validated, digital, and usually online health technologies intended to treat a medical or psychological condition; these are known as “digiceuticals” or digital therapeutics.  
 

Counterfeit Strips

People with diabetes should be advised against purchasing or reselling preowned or secondhand test strips, as these may give incorrect results. Only unopened and unexpired vials of glucose test strips should be used to ensure BGM accuracy.

Read more: Diabetes !! Diabetes mellitus !! Type 1 Diabetes !! Type 2 Diabetes !! Diabetes Symptoms !! Treatment for diabetes

Reference

1.    American Diabetes Association Releases 2023 Standards of Care in Diabetes to Guide Prevention, Diagnosis, and Treatment for People Living with Diabetes. Press release, December 2022. Accessed from https://diabetes.org/newsroom/press-releases/2022/american-diabetes-association-2023-standards-care-diabetes-guide-for-prevention-diagnosis-treatment-people-living-with-diabetes.

2.   ElSayed NA, Aleppo G, Aroda VR, et al; on behalf of the American Diabetes Association. 7. Diabetes Technology: Standards of Care in Diabetes-2023. Diabetes Care. 2023 Jan 1;46(Suppl 1):S111-S127.

3.    Nuha A. ElSayed, Grazia Aleppo, et al; on behalf of the American Diabetes Association, Summary of Revisions: Standards of Care in Diabetes—2023. Diabetes Care 1 January 2023; 46 (Supplement_1): S5–S9.