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Summary of Revisions for the 2009 Clinical Practice Recommendations

Diabetes Care
American Diabetes Association
Publication Date
DOI: 10.2337/dc09-s003
  • Summary Of Revisions
  • Medicine


Summary of Revisions for the 2009 Clinical Practice Recommendations B eginning with the 2005 supple-ment, the Clinical Practice Recom-mendations contained only the “Standards of Medical Care in Diabetes” and selected other position statements. This change was made to emphasize the importance of the “Standards” as the best source to determine American Diabetes Association (ADA) recommendations. The position statements in the supple- ment are updated yearly. Position state- ments not included in the supplement will be updated as necessary and repub- lished when updated. A list of the position statements not included in this supple- ment appears on p. S98. Additions to the “Standards of Medical Care in Diabetes” ● A section on bariatric surgery has been added. ● A section on discharge planning has been added to “Diabetes care in the hos- pital.” Revisions to the “Standards of Medical Care in Diabetes” ● In the “Testing for type 2 diabetes in children” section, small-for- gestational-age birth weight has been added to the list of conditions associ- ated with insulin resistance. ● Testing should begin at age 10 years or at onset of puberty, if puberty occurs at a younger age, and should be repeated every 3 years. (E) ● In the “Prevention/delay of type 2 dia- betes” section, the recommendation has been revised to clarify that one-time counseling is not adequate. ● Patients with impaired glucose toler- ance (A) or impaired fasting glucose (E) should be referred to an effective ongo- ing support program for weight loss of 5–10% of body weight and for increas- ing physical activity to at least 150 min per week of moderate activity such as walking. Diabetes care: ● For patients using less frequent insulin injections, noninsulin therapies, or medical nutrition therapy and physical therapy alone, self-monitoring of blood glucose (SMBG) may be useful as a guide to the success of therapy. (E) ● In the “Glucose monitoring” section, continuous glucose monitoring (CGM) has been

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