New Standards of Care for Diabetes
The American Diabetes Association (ADA) — the leading diabetes advisory organization in the United States — is making changes to its Standards of Care. Every year, the ADA revises and makes changes to these Standards in order to keep pace with changing science and technology, and to provide the medical industry with the most complete information: Standards of Care generally provide insight for clinicians and other health professionals into all manner of factors related to diabetes care, such as prevention, testing, diagnosis, and management, etc.
Some of the most significant changes included new cardiovascular recommendations, such as:
- Cholesterol-lowering drugs for all patients with diabetes. Based on new guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA), patients will now be assessed based on their risk profiles, rather than their LDL levels. Since having diabetes is considered a risk factor in itself (a person with diabetes is two to four times more likely to experience a cardiovascular event than one without), the new Standards call for all people with diabetes to take a statin – the strength of which will be based on age and other cardiovascular risk factors.
- A less stringent diastolic blood pressure goal of 90 mmHg, instead of 80 mmHg;
Changing diagnostics for various at-risk populations:
- Lowering the BMI cut point for screening of overweight or obese Asian Americans (from 25 kg/m2 to 23 kg/m2), to better reflect that population’s higher type 2 diabetes risk;
- A new A1C target of less than 7.5% for children and adolescents;
- A call for the use of the A1C, and A1C percentage targets, for diagnosing and managing gestational diabetes; and
General guidelines for health and wellness of those living with and without diabetes, such as:
- A denouncing of e-cigarettes as not an adequate substitute for smoking or as an aid to smoking cessation;
- Regular exercising, as well as adding resistance training at least twice per week (unless otherwise recommended by personal physician for medical reasons);
- Breaking up large periods of inactivity (where we’re sitting down at a desk for example), into no more than 90 minute intervals;
- And a revision of the immunization guidelines for older adults over the age of 65, in order to reflect the recommendations of the Centers for Disease Control and Prevention in regards to pneumonia vaccination.
These guidelines will likely be received with some resistance by patients not too keen on being placed on yet another medication, particularly if their LDL levels do not reflect a need. Every person with diabetes should have a frank discussion with their medical team in order to assess risk, and progress, and the potential need for a change in diabetes management.