THE JOURNAL OF CLINICAL AND APPLIED RESEARCH AND EDUCATION VOLUME 40 | SUPPLEMENT 1 WWW.DIABETES.ORG/DIABETESCARE JANUARY 2017 PLE M E P N U T S 1 AMERICAN DIABETES ASSOCIATION STANDARDS OF MEDICAL CARE IN DIABETES—2017 ISSN 0149-5992 American Diabetes Association Standards of Medical Care in Diabetesd2017 January 2017 Volume 40, Supplement 1 [T]he simple word Care may suffice to express [the journal’s] philosophical mission. The new journal is designed to promote better patient care by serving the expanded needs of all health professionals committed to the care of patients with diabetes. As such, the American Diabetes Association views Diabetes Care as a reaffirmation of Francis Weld Peabody’s contention that “the secret of the care of the patient is in caring for the patient.” —Norbert Freinkel, Diabetes Care, January-February 1978 EDITOR IN CHIEF William T. Cefalu, MD ASSOCIATE EDITORS EDITORIAL BOARD George Bakris, MD Nicola Abate, MD Maureen Monaghan, PhD, CDE Lawrence Blonde, MD, FACP Vanita R. Aroda, MD Kristen J. Nadeau, MD, MS Andrew J.M. Boulton, MD Geremia Bolli, MD Kwame Osei, MD David D’Alessio, MD John B. Buse, MD, PhD Kevin A. Peterson, MD, MPH, FRCS(Ed), Mary de Groot, PhD Robert J. Chilton, DO, FACC, FAHA FAAFP Eddie L. Greene, MD Kenneth Cusi, MD, FACP, FACE Jonathan Q. Purnell, MD Frank B. Hu, MD, MPH, PhD Paresh Dandona, MD, PhD Peter Reaven, MD Steven E. Kahn, MB, ChB J. Hans DeVries, MD, PhD Ravi Retnakaran, MD, MSc, FRCPC Derek LeRoith, MD, PhD Ele Ferrannini, MD Helena Wachslicht Rodbard, MD Robert G. Moses, MD Franco Folli, MD, PhD Elizabeth Seaquist, MD Stephen Rich, PhD Meredith A. Hawkins, MD, MS Guntram Schernthaner, MD Matthew C. Riddle, MD Richard Hellman, MD David J. Schneider, MD Julio Rosenstock, MD Norbett Hermanns, PhD, MSc Norbert Stefan, MD William V. Tamborlane, MD George S. Jeha, MD Jan S. Ulbrecht, MB, BS Katie Weinger, EdD, RN Irl B. Hirsch, MD, MACP Joseph Wolfsdorf, MD, BCh Judith Wylie-Rosett, EdD, RD Lee M. Kaplan, MD, PhD Tien Yin Wong, MBBS, FRCSE, FRANZCO, M. Sue Kirkman, MD MPH, PhD Ildiko Lingvay, MD, MPH, MSCS Bernard Zinman, CM, MD, FRCPC, FACP Harold David McIntyre, MD, FRACP AMERICAN DIABETES ASSOCIATION OFFICERS CHAIR OF THE BOARD David A. DeMarco, PhD PRESIDENT, MEDICINE & SCIENCE Alvin C. Powers, MD PRESIDENT, HEALTH CARE & EDUCATION Brenda Montgomery, RN, MSHS, CDE SECRETARY/TREASURER Umesh Verma CHIEF EXECUTIVE OFFICER Kevin L. Hagan The mission of the American Diabetes Association is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Diabetes Care is a journal for the health care practitioner that is intended to increase knowledge, stimulate research, and promote better management of people with diabetes. To achieve these goals, the journal publishes original research on human studies in the following categories: Clinical Care/Education/Nutrition/ Psychosocial Research, Epidemiology/Health Services Research, Emerging Technologies and Therapeutics, Pathophysiology/Complications, and Cardiovascular and Metabolic Risk. The journal also publishes ADA statements, consensus reports, clinically relevant review articles, letters to the editor, and health/medical news or points of view. Topics covered are of interest to clinically oriented physicians, researchers, epidemiologists, psychologists, diabetes educators, and other health professionals. More information about the journal can be found online at care.diabetesjournals.org. Copyright © 2017 by the American Diabetes Association, Inc. All rights reserved. Printed in the USA. Requests for permission to reuse content should be sent to Copyright Clearance Center at www.copyright.com or 222 Rosewood Dr., Danvers, MA 01923; phone: (978) 750-8400; fax: (978) 646-8600. Requests for permission to translate should be sent to Permissions Editor, American Diabetes Association, at [email protected]. The American Diabetes Association reserves the right to reject any advertisement for any reason, which need not be disclosed to the party submitting the advertisement. Commercial reprint orders should be directed to Sheridan Content Services, (800) 635-7181, ext. 8065. Single issues of Diabetes Care can be ordered by calling toll-free (800) 232-3472, 8:30 A.M. to 5:00 P.M. EST, Monday through Friday. Outside the United States, call (703) 549-1500. Rates: $75 in the United States, $95 in Canada and Mexico, and $125 for all other countries. Diabetes Care is available online at care.diabetesjournals.org. Please call the numbers listed above, e-mail [email protected], or visit the online journal for more information about submitting manuscripts, publication charges, ordering reprints, PRINT ISSN 0149-5992 subscribing to the journal, becoming an ADA member, advertising, permission to reuse ’ ONLINE ISSN 1935-5548 content, and the journal s publication policies. PRINTED IN THE USA Periodicals postage paid at Alexandria, VA, and additional mailing offices. AMERICAN DIABETES ASSOCIATION PERSONNEL AND CONTACTS VICE PRESIDENT, PUBLISHER EDITORIAL CONTENT MANAGER ADVERTISING SALES Michael Eisenstein Nancy C. Baldino ASSOCIATE PUBLISHER, PHARMACEUTICAL/DEVICE DIGITAL ADVERTISING SCHOLARLY JOURNALS TECHNICAL EDITORS e-Healthcare Solutions Christian S. Kohler Oedipa Rice John Burke Theresa Cooper Chief Revenue Officer EDITORIAL OFFICE DIRECTOR [email protected] Lyn Reynolds ASSOCIATE DIRECTOR, BILLING & COLLECTIONS (609) 882-8887, ext. 149 PEER REVIEW MANAGER Laurie Ann Hall Shannon Potts PHARMACEUTICAL/DEVICE PRINT ADVERTISING DIRECTOR, MEMBERSHIP/SUBSCRIPTION The Jackson-Gaeta Group, Inc. EDITORIAL ASSISTANT SERVICES B. Joseph Jackson Joan Garrett Donald Crowl [email protected] DIRECTOR, SCHOLARLY JOURNALS Paul Nalbandian SENIOR ADVERTISING MANAGER Heather Norton Blackburn [email protected] Julie DeVoss Graff Tina Auletta CONTENT PRODUCTION MANAGER [email protected] [email protected] Kelly Newton (703) 299-5511 (973) 403-7677 January 2017 Volume 40, Supplement 1 Standards of Medical Care in Diabetes—2017 S1 Introduction S75 9. Cardiovascular Disease and Risk S3 Professional Practice Committee Management S4 Standards of Medical Care in Diabetes—2017: Hypertension/Blood Pressure Control Summary of Revisions Lipid Management S6 1. Promoting Health and Reducing Disparities in Antiplatelet Agents Populations Coronary Heart Disease Diabetes and Population Health S88 10. Microvascular Complications and Tailoring Treatment to Reduce Disparities Foot Care S11 2. Classification and Diagnosis of Diabetes Diabetic Kidney Disease Diabetic Retinopathy Classification Neuropathy Diagnostic Tests for Diabetes Foot Care Categories of Increased Risk for Diabetes (Prediabetes) Type 1 Diabetes S99 11. Older Adults Type 2 Diabetes Gestational Diabetes Mellitus Neurocognitive Function Monogenic Diabetes Syndromes Hypoglycemia Cystic Fibrosis–Related Diabetes Treatment Goals Posttransplantation Diabetes Mellitus Pharmacologic Therapy Treatment in Skilled Nursing Facilities S25 3. Comprehensive Medical Evaluation and and Nursing Homes Assessment of Comorbidities End-of-Life Care Patient-Centered Collaborative Care S105 12. Children and Adolescents Comprehensive Medical Evaluation Assessment of Comorbidities Type 1 Diabetes Type 2 Diabetes S33 4. Lifestyle Management Transition From Pediatric to Adult Care Diabetes Self-management Education and Support Nutrition Therapy S114 13. Management of Diabetes in Pregnancy Physical Activity Diabetes in Pregnancy Smoking Cessation: Tobacco and e-Cigarettes Preconception Counseling Psychosocial Issues Glycemic Targets in Pregnancy Management of Gestational Diabetes Mellitus S44 5. Prevention or Delay of Type 2 Diabetes Management of Preexisting Type 1 Diabetes Lifestyle Interventions and Type 2 Diabetes in Pregnancy Pharmacologic Interventions Postpartum Care Prevention of Cardiovascular Disease Pregnancy and Drug Considerations Diabetes Self-management Education and Support S120 14. Diabetes Care in the Hospital S48 6. Glycemic Targets Hospital Care Delivery Standards Assessment of Glycemic Control Glycemic Targets in Hospitalized Patients A1C Testing Bedside Blood Glucose Monitoring A1C Goals Antihyperglycemic Agents in Hospitalized Hypoglycemia Patients Intercurrent Illness Hypoglycemia S57 7. Obesity Management for the Treatment of Type 2 Medical Nutrition Therapy in the Hospital Diabetes Self-management in the Hospital Standards for Special Situations Assessment Transition From the Acute Care Setting Diet, Physical Activity, and Behavioral Therapy Preventing Admissions and Readmissions Pharmacotherapy Metabolic Surgery S128 15. Diabetes Advocacy S64 8. Pharmacologic Approaches to Glycemic Advocacy Position Statements Treatment S130 Professional Practice Committee Disclosures Pharmacologic Therapy for Type 1 Diabetes Pharmacologic Therapy for Type 2 Diabetes S132 Index This issue is freely accessible online at care.diabetesjournals.org. Keep up with the latest information for Diabetes Care and other ADA titles via Facebook (/ADAJournals) and Twitter (@ADA_Journals). Diabetes Care Volume 40, Supplement 1, January 2017 S1 INTRODUCTION Introduction Diabetes Care 2017;40(Suppl. 1):S1–S2 | DOI: 10.2337/dc17-S001 Diabetes is a complex, chronic illness re- ADA’s clinical practice recommendations Consensus Report quiring continuous medical care with are viewed as important resources for A consensus report contains a compre- multifactorial risk-reduction strategies health care professionals who care for hensive examination by an expert panel beyond glycemic