Standards of Medical Care in Diabetes

2016 ADA Guideline Recommendations
Types of Diabetes Mellitus
Main Diabetes Page
Diabetes type I
Diabetes type II
Gestational Diabetes Mellitus
2016 ADA Standard of Medical Care Guideline Recommendations
Strategies for Improving Care
Classification and Diagnosis of Diabetes
Foundations of Care and Comprehensive Medical Evaluation Diabetes Self-Management, Education, and Support Nutritional Therapy
Prevention or Delay of Type II Diabetes
Glycemic Targets
Obesity Management for Treatment of Type II Diabetes
Approaches to Glycemic Treatment
Cardiovascular Disease and Risk Management Hypertension and Blood Pressure Control Lipid Management Antiplatelet Agents Coronary Heart Disease
Microvascular Complications and Foot Care Diabetic Kidney Disease Diabetic Retinopathy Diabetic Neuropathy Diabetic Footcare
Older Adults with Diabetes
Children and Adolescents with Diabetes Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes Microvascular Complications in Children and Adolescents with Diabetes
Management of Diabetes in Pregnancy
Diabetes Care in the Hospital Setting

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]

V. Diabetes Care

C. Glycemic Control

1. Assessment of Glycemic Control

a. Glucose Monitoring

b. A1C

2. Glycemic Goals in Adults

D. Pharmacological and Overall Approaches to Treatment

1. Insulin Therapy for Type 1 Diabetes

2. Pharmacological Therapy for Hyperglycemia in Type 2 Diabetes

E. Medical Nutrition Therapy

• General Recommendations
• Energy Balance, Overweight, and Obesity
• Eating Patterns and Macronutrient Distribution
• Carbohydrate Amount and Quality
• Dietary Fat Quantity and Quality
• Supplements for Diabetes Management
• Alcohol
• Sodium
• Primary Prevention of Type 2 Diabetes

G. Physical Activity

• Frequency and Type of Exercise
• Pre-exercise Evaluation of the Diabetic Patient
• Exercise in the Presence of Nonoptimal Glycemic Control

• Hyperglycemia
• Hypoglycemia

• Exercise in the Presence of Specific Long-Term Complications of Diabetes

• Retinopathy
• Peripheral Neuropathy
• Autonomic Neuropathy
• Albuminuria and Nephropathy

VI. Prevention and Management of Diabetes Complications

A. Cardiovascular Disease

1. Hypertension/Blood Pressure Control

• Recommendations

• Screening and Diagnosis
• Goals
• Treatment

2. Dyslipidemia/Lipid Management

• Recommendations

• Screening
• Treatment Recommendations and Goals

3. Antiplatelet Agents

4. Smoking Cessation

5. Cardiovascular Disease

• Recommendations

• Screening
• Treatment

B. Nephropathy

• Recommendations

• General Recommendations
• Screening
• Treatment

C. Retinopathy

• Recommendations

• General Recommendations
• Screening
• Treatment

D. Neuropathy

• Recommendations
• Diagnosis of Neuropathy

• Distal Symmetric Polyneuropathy
• Diabetic Autonomic Neuropathy
• Cardiovascular Autonomic Neuropathy
• Gastrointestinal Neuropathies
• Genitourinary Tract Disturbances

• Treatment

• Glycemic Control
• Distal Symmetric Polyneuropathy
• Autonomic Neuropathy
• Orthostatic Hypotension
• Gastroparesis Symptoms
• Erectile Dysfunction

VIII. Diabetes Care in Specific Populations

A. Children and Adolescents

1. Type 1 Diabetes

a. Glycemic Control

b. Screening and Management of Complications

i. Nephropathy

ii. Hypertension

iii. Dyslipidemia

iv. Retinopathy

v. Celiac Disease

vi. Hypothyroidism

c. Self-Management

d. School and Day Care

e. Transition From Pediatric to Adult Care

2. Type 2 Diabetes

3. Monogenic Diabetes Syndromes

IX. Diabetes Care in Specific Settings

A. Diabetes Care in the Hospital

1. Glycemic Targets in Hospitalized Patients

2. Antihyperglycemic Agents in Hospitalized Patients

3. Preventing Hypoglycemia

4. Diabetes Care Providers in the Hospital

5. Self-Management in the Hospital

6. MNT in the Hospital

7. Bedside Blood Glucose Monitoring

8. Discharge Planning and DSME

X. Strategies for Improving Diabetes Care

Adapted from Standards of Medical Care in Diabetes—2014 by the American Diabetes Association