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2016 Standards of Medical Care in Diabetes THE JOURNAL OF CLINICAL AND APPLIED RESEARCH AND EDUCATION VOLUME 39 | SUPPLEMENT 1 WWW.DIABETES.ORG/DIABETESCARE JANUARY 2016 PLE M E P N U T S 1 AMERICAN DIABETES ASSOCIATION STANDARDS OF MEDICAL CARE IN DIABETES—2016 ISSN 0149-5992 American Diabetes Association Standards of Medical Care in Diabetesd2016 January 2016 Volume 39, 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 Rita Rastogi Kalyani, MD, MHS, FACP Lawrence Blonde, MD, FACP Silva Arslanian, MD Rory J. McCrimmon, MBChB, MD, FRCP Andrew J.M. Boulton, MD Angelo Avogaro, MD, PhD Harold David McIntyre, MD, FRACP David D’Alessio, MD Ananda Basu, MD, FRCP Gianluca Perseghin, MD Sherita Hill Golden, MD, MHS, FAHA John B. Buse, MD, PhD Anne L. Peters, MD Mary de Groot, PhD Sonia Caprio, MD Jonathan Q. Purnell, MD Eddie L. Greene, MD Robert Chilton, DO Peter Reaven, MD Frank B. Hu, MD, MPH, PhD Kenneth Cusi, MD, FACP, FACE Helena Wachslicht Rodbard, MD Derek LeRoith, MD, PhD Paresh Dandona, MD, PhD David J. Schneider, MD Robert G. Moses, MD Stefano Del Prato, MD Elizabeth R. Seaquist, MD Stephen Rich, PhD Dariush Elahi, PhD Norbert Stefan, MD Matthew C. Riddle, MD Franco Folli, MD, PhD Jeff Unger, MD Julio Rosenstock, MD Robert G. Frykberg, DPM, MPH Ram Weiss, MD, PhD William V. Tamborlane, MD W. Timothy Garvey, MD Deborah J. Wexler, MD, MSc Katie Weinger, EdD, RN Ronald B. Goldberg, MD Joseph Wolfsdorf, MD, BCh Judith Wylie-Rosett, EdD, RD Margaret Grey, DrPH, RN, FAAN Tien Yin Wong, MBBS, FRCSE, FRANZCO, Richard Hellman, MD MPH, PhD AMERICAN DIABETES ASSOCIATION OFFICERS CHAIR OF THE BOARD PRESIDENT-ELECT, MEDICINE & SCIENCE Robin J. Richardson Alvin C. Powers, MD PRESIDENT, MEDICINE & SCIENCE PRESIDENT-ELECT, HEALTH CARE & Desmond Schatz, MD EDUCATION Brenda Montgomery, RN, MSHS, CDE PRESIDENT, HEALTH CARE & EDUCATION Margaret A. Powers, PhD, RD, CDE SECRETARY/TREASURER-ELECT Umesh Verma SECRETARY/TREASURER Lorrie Welker Liang CHIEF EXECUTIVE OFFICER Kevin L. Hagan CHAIR OF THE BOARD-ELECT David A. DeMarco, PhD CHIEF SCIENTIFIC & MEDICAL OFFICER Robert E. Ratner, MD, FACP, FACE 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 © 2016 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 PRINT ISSN 0149-5992 more information about submitting manuscripts, publication charges, ordering reprints, ONLINE ISSN 1935-5548 subscribing to the journal, becoming an ADA member, advertising, permission to reuse PRINTED IN THE USA content, and the journal’s publication policies. AMERICAN DIABETES ASSOCIATION PERSONNEL AND CONTACTS EDITORIAL OFFICE DIRECTOR PRODUCTION MANAGER DIRECTOR, MEMBERSHIP/SUBSCRIPTION Lyn Reynolds Amy S. Gavin SERVICES Donald Crowl PEER REVIEW MANAGER TECHNICAL EDITOR PHARMACEUTICAL DIGITAL ADVERTISING Shannon Potts Oedipa Rice e-Healthcare Solutions John Burke EDITORIAL OFFICE SECRETARIES Chief Revenue Officer Raquel Castillo MANAGING DIRECTOR, MEDIA SALES Clare Liberis [email protected] Joan Garrett [email protected] (609) 882-8887, ext. 149 (212) 725-4925, ext. 3448 MANAGING DIRECTOR, SCHOLARLY PHARMACEUTICAL PRINT ADVERTISING JOURNAL PUBLISHING The Jackson-Gaeta Group, Inc. Christian S. Kohler ADVERTISING MANAGER B. Joseph Jackson Julie DeVoss Graff [email protected] DIRECTOR, SCHOLARLY JOURNAL PUBLISHING [email protected] Heather Norton Blackburn Paul Nalbandian (703) 299-5511 [email protected] EDITORIAL MANAGERS Tina Auletta Valentina Such ASSOCIATE DIRECTOR, BILLING & COLLECTIONS [email protected] Nancy C. Baldino Laurie Ann Hall (973) 403-7677 January 2016 Volume 39, Supplement 1 Standards of Medical Care in Diabetes—2016 S1 Introduction S60 8. Cardiovascular Disease and Risk S3 Professional Practice Committee Management S4 Standards of Medical Care in Diabetes—2016: Hypertension/Blood Pressure Control Summary of Revisions Lipid Management S6 1. Strategies for Improving Care Antiplatelet Agents Coronary Heart Disease Diabetes Care Concepts Care Delivery Systems S72 9. Microvascular Complications and Foot Care When Treatment Goals Are Not Met Diabetic Kidney Disease Tailoring Treatment to Vulnerable Populations Diabetic Retinopathy S13 2. Classification and Diagnosis of Diabetes Neuropathy Classification Foot Care Diagnostic Tests for Diabetes S81 10. Older Adults Categories of Increased Risk for Diabetes (Prediabetes) Type 1 Diabetes Overview Type 2 Diabetes Neurocognitive Function Gestational Diabetes Mellitus Hypoglycemia Monogenic Diabetes Syndromes Treatment Goals Cystic Fibrosis–Related Diabetes Pharmacological Therapy Treatment in Skilled Nursing Facilities S23 3. Foundations of Care and Comprehensive Medical Evaluation and Nursing Homes End-of-Life Care Foundations of Care S86 11. Children and Adolescents Basis for Initial Care Ongoing Care Management Type 1 Diabetes Diabetes Self-management Education and Support Type 2 Diabetes Medical Nutrition Therapy Transition From Pediatric to Adult Care Physical Activity S94 12. Management of Diabetes in Pregnancy Smoking Cessation: Tobacco and e-Cigarettes Immunization Diabetes in Pregnancy Psychosocial Issues Preconception Counseling Comprehensive Medical Evaluation Glycemic Targets in Pregnancy Comorbidities Management of Gestational Diabetes Mellitus Management of Pregestational Type 1 Diabetes S36 4. Prevention or Delay of Type 2 Diabetes and Type 2 Diabetes in Pregnancy Lifestyle Modification Postpartum Care Pharmacological Interventions Pregnancy and Antihypertensive Drugs Diabetes Self-management Education and Support S99 13. Diabetes Care in the Hospital S39 5. Glycemic Targets Hospital Care Delivery Standards Assessment of Glycemic Control Considerations on Admission A1C Testing Glycemic Targets in Hospitalized Patients A1C Goals Antihyperglycemic Agents in Hospitalized Hypoglycemia Patients Intercurrent Illness Standards for Special Situations Treating and Preventing Hypoglycemia S47 6. Obesity Management for the Treatment of Type 2 Diabetes Self-management in the Hospital Medical Nutrition Therapy in the Hospital Look AHEAD Transition From the Acute Care Setting Assessment Diabetes Care Providers in the Hospital Diet, Physical Activity, and Behavioral Therapy Bedside Blood Glucose Monitoring Pharmacotherapy S105 14. Diabetes Advocacy Bariatric Surgery S52 7. Approaches to Glycemic Treatment Advocacy Position Statements S107 Professional Practice Committee for the Standards Pharmacological Therapy for Type 1 Diabetes of Medical Care in Diabetes—2016 Pharmacological Therapy for Type 2 Diabetes Bariatric Surgery S109 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 39, Supplement 1, January 2016 S1 INTRODUCTION Introduction Diabetes Care 2016;39(Suppl. 1):S1–S2 | DOI: 10.2337/dc16-S001 Diabetes is a complex, chronic illness re- diabetes care standards, guidelines, and to diabetes. Workgroup
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