Kaitlin Bredenkamp, PharmD; Minnesota Community Care
Background: The Standards of Care in Diabetes - 2024 is the latest update to clinical practice guidelines for diabetes management as put forward by the American Diabetes Association (ADA). Each year, the ADA’s Professional Practice Committee reviews current literature to ensure that the clinical practice guidelines promote the best evidence-based clinical interventions. Updates reflected in the Standards of Care in Diabetes - 2024 include revisions to terminology, medication recommendations, positive health behavior and weight management recommendations, monitoring technology recommendations, comorbidity risk reduction and monitoring recommendations, and considerations for special populations.
Evidence/Discussion: Several sections include general updates to language and terminology, particularly focused on inclusive and culturally sensitive language, while other sections advocate for the benefits of diabetes technology, such as continuous glucose monitors and automated insulin devices, and discuss the use of telehealth in diabetes management.
The following table outlines specific medication-related changes:
Section | Medication Related Updates |
3: Prevention or Delay of Diabetes and Associated Comorbidities |
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4: Comprehensive Medical Evaluation and Assessment of Comorbidities |
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5: Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes |
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8: Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes |
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9: Pharmacologic Approaches to Glycemic Treatment |
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10: Cardiovascular Disease and Risk Management |
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11: Chronic Kidney Disease and Risk Management |
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13: Older Adults |
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14: Children and Adolescents |
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15: Management of Diabetes in Pregnancy |
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Abbreviations: ACEi, Angiotensin-Converting Enzyme Inhibitors; ARB, Angiotensin Receptor Blockers; ASCVD, Atherosclerotic Cardiovascular Disease; CKD, Chronic Kidney Disease; CV, Cardiovascular; GDM, Gestational Diabetes Mellitus; GIP, Gastric Inhibitory Peptide; GLP1, Glucagon-like Peptide-1; HF, Heart Failure; PCSK-9i, Proprotein Convertase Subtilisin-Kexin type 9 Inhibitors; SGLT2i, Sodium-Glucose Cotransporter-2 Inhibitors
Clinical Impact: The overall updates are designed to help practitioners make the best clinical decisions for patients with diabetes. The updates provide specific guidance on agent selection where decisions may have otherwise been vague and re-evaluate diabetes in special populations, particularly those with comorbidities, advanced age, and/or pregnancy as therapies continue to evolve.. Much of diabetes care remains the same as previous years, but care decisions become more and more nuanced as new agents are developed.
Citations:
- American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan 1;47(Supplement_1):S5-S10.
- ElSayed NA, Aleppo G, Aroda VR, et al, on behalf of the American Diabetes Association. Summary of Revisions: Standards of Care in Diabetes-2023. Diabetes Care. 2023 Jan 1;46(Suppl 1):S5-S9.