Wednesday, August 7, 2019

ADA updates its 2019 Standards of Medical Care in Diabetes

Dr KK Aggarwal

The American Diabetes Association (ADA) has updated its 2019 Standards of Medical Care in Diabetes by incorporating recently related published research.

  • Based on the results of the REWIND (Researching Cardiovascular Events With a Weekly Incretin in Diabetes) trial, dulaglutide, the once-weekly GLP-1 agonist, is now recognized among other GLP1 receptor agonists that have demonstrated macrovascular benefits in people with type 2 diabetes in section 9 “Pharmacologic Approaches to Glycemic Treatment” and Section 10 “Cardiovascular Disease Risk Management”. The REWIND trial indicated that dulaglutide reduced the risk for nonfatal myocardial infarction, nonfatal stroke and cardiovascular death in adults with type 2 diabetes with and without established cardiovascular disease. This update has also been approved by the American College of Cardiology

  • Section 13 “Children and adolescents” now advises liraglutide for some children and adolescents following its approval by the US FDA for use in pediatric patients with type 2 diabetes who are 10 years of age and older, and the Liraglutide in Children and Adolescents with Type 2 Diabetes study, which examined its effects on the youth… “If glycemic targets are no longer met with metformin ± basal insulin, liraglutide therapy should be considered in children 10 years or older, if no history or family history of medullary thyroid carcinoma.”

  • The new international consensus report on continuous glucose monitoring (CGM) time-in-range goals has been added in Section 6, Glycemic Targets, and Section 7, Diabetes Technology. A table has been added to help standardize CGM metrics for clinical care and an example of an ambulatory glucose profile has been added to encourage consistency in CGM data report interpretation

These updates have been published online July 31, 2019 in the journal Diabetes Care. 

(Source: ADA News Release, Medscape)

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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