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