Sweet Morsels: The Top 10 Things to Know About the Revisions to the 2016 ADA Guidelines
The American Diabetes Association (ADA) publishes an updated “Standards of Medical Care in Diabetes” each year in order to educate on various components of diabetes care. Although not intended to preclude clinical judgment, it provides evidence-based recommendations on screening, diagnostic, and therapeutic interventions in order to optimally treat patients with diabetes. Here are 10 important changes to the 2016 guidelines:
You can never test too soon. Major clinical trials have not been completed to prove the effectiveness of early screening in asymptomatic adults, but mathematical modeling studies suggest potential benefit. Furthermore, beginning screening at age 30 or 45—independent of risk factors—may be cost-effective. Thus, the recommendation to start testing for diabetes is explicitly stated at age 45, regardless of weight. Earlier testing is still recommended for asymptomatic adults of any age who are overweight and have one or more additional risk factors.
There are various ways to diagnose diabetes. The diagnosis of diabetes is based on the plasma glucose criteria, which includes the fasting plasma glucose, two-hour plasma glucose after an oral glucose tolerance test, or the A1C. These tests are used both in the diagnosis and screening of diabetes and the guidelines now emphasize that no one diagnostic test is preferred over another.