Diabetes is a common chronic illness in the United States. More than 21 million people were diagnosed in the US in 2014. Proper diagnosis and management are important to control this ever-growing disease. On January 2015, the American Diabetes Association published a new guideline called, “Standards of Medical Care In Diabetes - 2015”. This guideline is a revision of the 2014 guidelines. The followings sections have been updated in the new guideline.
Classification and Diagnosis of Diabetes
The BMI criteria for prediabetes or type 2 diabetes screening in Asian Americans has changed from 25 kg/m2 to 23 kg/m2 because new evidence suggests that Asian Americans have an increased risk of diabetes at a lower BMI.
Foundations of Care: Education, Nutrition, Physical Activity, Smoking Cessation, Psychosocial Care, and Immunization
All individuals, including diabetics, should avoid sitting for more than 90 minutes.
E-cigarettes are not an alternative to smoking because there is a lack of evidence that shows e-cigarettes are a healthier alternative to smoking or that they facilitate smoking cessation.
To better reflect the recent changes in the CDC guideline regarding pneumococcal vaccinations, the following revision have been made: Adults at or over the age of 65, who have not been previously vaccinated, should receive the pneumococcal conjugate vaccine 13 (PCV13) followed by the pneumococcal polysaccharide vaccine 23 (PPSV23) 6-12 months after. Adults at or over the age of 65, who have previously been vaccinated with PPSV23, should receive PCV13 at or 12 months after the PPSV23.
Blood Glucose Targets
The pre-meal blood glucose target has been changed from 70-130 mg/dL to 80-130 mg/dL because new evidence showed that this range reflects A1C targets.
To improve adherence, patient readiness assessment is required for optimal usage of continuous glucose monitoring (CGM). Ongoing continuous glucose monitoring education should be also provided.