Johnson EL, Pfotenhauer K, Bradley S, Kalyani RR, Shubrook JH. Highlights From the American Diabetes Association's 2017 Standards of Medical Care in Diabetes for Osteopathic Physicians. J Am Osteopath Assoc 2017;117(7):457–472. doi: https://doi.org/10.7556/jaoa.2017.086.
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The American Diabetes Association (ADA) updates its Standards of Medical Care (SOMC) in Diabetes annually. These ADA standards make up a comprehensive document that serves as an excellent resource for clinical care. The current article comes from the ADA's Primary Care Advisory Group. This article highlights key aspects of the SOMC that are relevant to the day-to-day practice of osteopathic primary care physicians. It is not intended to replace the full SOMC but will refer to the master document for further explanation and evidence-based support.
Source: Adapted from Table 1 in the Standards of Medical Care in Diabetes—2017.1
a See section 13 for gestational diabetes mellitus information.
b In the absence of unequivocal hyperglycemia, results should be confirmed by repeated testing.
Abbreviations: HbA1c, hemoglobin A1c; DCCT, Diabetes Control and Complications Trial; FPG, fasting plasma glucose; OGTT, oral glucose tolerance test; PG, plasma glucose; WHO, World Health Organization.
Source: Adapted from Table 2.2 in the Standards of Medical Care in Diabetes—2017.1
a More or less stringent glycemic goals may be appropriate for individual patients. Goals should be individualized based on duration of diabetes, age/life expectancy, comorbidities, known cardiovascular disease or advanced microvascular complications, hypoglycemia unawareness, and individual patient considerations.
b Postprandial glucose may be targeted if hemoglobin A1c (HbA1c) goals are not met despite reaching preprandial glucose goals. Measurements should be made 1-2 h after the beginning of the meal, generally peak levels in patients with diabetes.
Source: Adapted from Table 6.2 in the Standards of Medical Care in Diabetes—2017.1
a In addition to lifestyle therapy.
b Atherosclerotic cardiovascular disease (ASCVD) risk factors include low-density lipoprotein cholesterol (LDL-C) ≥100 mg/dL (2.6 mmol/L), high blood pressure, smoking, chronic kidney disease, albuminuria, and family history of premature ASCVD.
Abbreviation: ACS, acute coronary syndrome.
Source: Reprinted from Table 9.1 in the Standards of Medical Care in Diabetes—2017.1
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