Foundations of Care and Comprehensive Medical Evaluation
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2016 ADA Guideline Recommendations |
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Types of Diabetes Mellitus |
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2016 ADA Standard of Medical Care Guideline Recommendations |
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Cardiovascular Disease and Risk Management |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]; Tarek Nafee, M.D. [3]
2016 ADA Standards of Medical Care in Diabetes Guidelines[1]
PHYSICAL ACTIVITY
| "1. Children with diabetes or prediabetes should be encouraged to en- gage in at least 60 min of physical activity each day. (Level of Evidence: B)" |
| "2. Adults with diabetes should be advised to perform at least 150 min/ week of moderate-intensity aerobic physical activity (50–70% of maxi- mum heart rate), spread over at least 3 days/week with no more than 2 consecutive days without exercise. (Level of Evidence: A)" |
| "3. All individuals, including those with diabetes, should be encouraged to reduce sedentary time, particularly by breaking up extended amounts of time (>90 min) spent sitting. (Level of Evidence: B)" |
| "4. In the absence of contraindications, adults with type 2 diabetes should be encouraged to perform resistance training at least twice per week. (Level of Evidence: A)" |
SMOKING CESSATION: TOBACCO AND e-CIGARETTES
| "1. Advise all patients not to use cigarettes, other tobacco products, or e-cigarettes. (Level of Evidence: A)" |
| "2.Include smoking cessation coun- seling and other forms of treatment as a routine component of diabetes care. (Level of Evidence: B)" |
IMMUNIZATION
| "1. Provide routine vaccinations for children and adults with diabetes as for the general population according to age-related recommendations (Level of Evidence: C)" |
| "2.Administer hepatitis B vaccine to unvaccinated adults with diabetes who are aged 19–59 years. (Level of Evidence: C)" |
| "3. Consider administering hepatitis B vaccine to unvaccinated adults with diabetes who are aged ≥60 years. (Level of Evidence: C)" |
PSYCHOSOCIAL ISSUES
| "1. The patient’s psychological and social situation should be addressed in the medical management of diabetes. (Level of Evidence: B)" |
| "2. Psychosocial screening and follow-up may include, but are not limited to, attitudes about the illness, expectations for medical management and outcomes, affect/ mood, general and diabetes-related quality of life, resources (financial, social, and emotional), and psychiatric history. (Level of Evidence: E)" |
| "3.Routinely screen for psychosocial problems such as depression, diabetes-related distress, anxiety, eating disorders, and cognitive impairment. (Level of Evidence: B)" |
| "4. Older adults (aged ≥65 years) with diabetes should be considered for evaluation of cognitive function and depression screening and treatment. (Level of Evidence: B)" |
| "5. Patients with comorbid diabetes and depression should receive a stepwise collaborative care approach for the management of depression (Level of Evidence: A)" |
COMPREHENSIVE MEDICAL EVALUATION
A complete medical evaluation should be performed at the initial visit to| "1. Confirm the diagnosis and classify
diabetes (Level of Evidence: B)" |
| "2. Detect diabetes complications and
potential comorbid conditions. (Level of Evidence: E)" |
| "3.Review previous treatment and risk factor control in patients
with established diabetes (Level of Evidence: E)" |
| "4. Begin patient engagement in the formulation of a care management plan. (Level of Evidence: B)" |
| "5. Develop a plan for continuing care (Level of Evidence: B)" |
- ↑ "care.diabetesjournals.org" (PDF).