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​Clinical Practice Guidelines

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Evidence-based Clinical Practice Guidelines (CPGs) are available on a range of subjects, including preventive care, diabetes, asthma, depression, tobacco cessation and attention-deficit / hyperactivity disorder (ADHD). All CPGs are developed with input from practitioners in Unity’s provider network. New and existing CPGs are reviewed and adopted at least every two years. To view the complete list of guidelines, visit unityhealth.com/clinicalguidelines.

Summary of Revisions to the 2016 Diabetes Clinical Practice Recommendations


The following sections have undergone changes –

Section 1.  Strategies for Improving Care: clarified to include recommendations on tailoring treatment to vulnerable populations with diabetes.

Section 2.  Classifications and Diagnosis of Diabetes testing recommendation: to test all adults beginning at age 45 years, regardless of weight. Testing is also recommended for asymptomatic adults of any age who are overweight or obese and who have one or more additional risk factors for diabetes.

Section 3.  Foundations of Care and Comprehensive Medical Evaluation:  sections from the 2015 Standards were combined to reflect the importance of integrating medical evaluation, patient engagement and ongoing care highlighting the importance of lifestyle and behavioral modification. 

Section 4.  Prevention or Delay of Type 2 Diabetes: updated to reflect the changing role of technology in the prevention of type 2 diabetes.

Section  5.  Glycemic Targets for insulin-dependent adults using continuous glucose monitoring and insulin pumps:  continued access after age 65.

Section 6.  Obesity Management for the Treatment of Type 2 Diabetes:  include new recommendations related to the comprehensive assessment of weight in diabetes and to the treatment of overweight / obesity with behavior modification and pharmacotherapy.

Section 7.  Approaches to Glycemic Treatment:  Bariatric surgery was removed from this section and moved to Section 6.

Section 8.  Cardiovascular Disease and Risk Management:  the term Cardiovascular Disease (CVD) was replaced with Arthrosclerotic Cardiovascular Disease (ASCVD).  Aspirin therapy in women older than age 60 now includes women aged 50 years and older.

Section 9.  Microvascular Complications and Foot Care: the term “nephropathy” was removed and replaced with the more specific term “diabetic kidney disease”.  Neuropathy may stem from diabetes or a host of other conditions.

Section 10.  Older Adults section expansion: this comprehensive section better captures the nuances of diabetes care in the older adult population.

Section 11.  Children and Adolescents section expansion:  this comprehensive section better captures the nuances of diabetes care in the pediatric population.

Section 12.  Management of Diabetes in Pregnancy:  Now includes new recommendations on progestational diabetes, gestational diabetes and general principles for diabetes management in pregnancy.

Section 13.  Diabetes Care in the Hospital:  revised to focus solely on diabetes care in the hospital setting.

Section 14.  Diabetes Advocacy: revised to separate diabetes care in the school setting and the day-care setting. 

A copy of the full Clinical Practice Guideline for Diabetes

Reference: Diabetes Care 2016;39(Suppl. 1):S4–S5 | DOI: 10.2337/dc16-S003

Hypertension Clinical Practice Guidelines – 2016


A UW Health multi-disciplinary group has updated the Hypertension Clinical Practice Guideline for adults 18 years and older.


After a comprehensive evaluation of available national guidelines and trials, the workgroup based this guideline primarily on the 2013 Clinical Practice Guidelines for the Management of Hypertension in the Community: A Statement by the American Society of Hypertension and the International Society of Hypertension.


Key Revisions (2016-Focused Periodic Review)

  1. Endorsed U.S. Preventive Services Task Force (USPSTF) blood pressure screening recommendations.
  2. Revised blood pressure treatment goals based on recent publications (e.g., SPRINT).
  3. Additional lab monitoring for BUN, fasting glucose, and annual lipid testing are no longer recommended based on a diagnosis of hypertension alone. However, these tools can be considered for individual patients.
  4. Removed recommendation for Mediterranean diet as primary dietary intervention for patients with hypertension. 

Key Practice Recommendations

  1. This guideline and the USPSTF recommend obtaining blood pressure measurements outside of the clinical setting to confirm a new diagnosis of hypertension before starting treatment. Additional out-of-clinic readings are also recommended in patients suspected of having “white coat” or “masked” hypertension. Patients should be advised to monitor their blood pressure one to two times per day, five days per week for one to two weeks. They should share this information with their provider.
  2. Patients with a new diagnosis of hypertension should have an evaluation for possible secondary causes of hypertension, especially obstructive sleep apnea.
  3. Lifestyle modifications are the cornerstone of treatment for every patient (See Table 5 Lifestyle Modifications on page 10 of the Clinical Practice Guideline). Educate all patients to limit their sodium intake to 1,500 to 2,400 mg / day.
  4. An ACE-inhibitor (or angiotensin receptor blocker) and / or a long-acting dihydropyridine calcium channel blocker may be a more effective initial medication regimen than a thiazide or thiazide-type diuretic.
  5. Chlorthalidone (12.5 to 25 mg daily) is the recommended thiazide-type diuretic, rather than hydrochlorothiazide (HCTZ).

The guideline can be found here. The Unity Drug Formulary will list the preferred drug products available at the lowest copay for your patients