According to the American Diabetes Association’s latest recommendations, diabetes management requires a more aggressive approach than previously advised.
The organization’s 2023 standard of care guidelines, released Monday, include nearly 100 new or revised recommendations that affect all types of diabetes. The most notable updates include stricter parameters for maintaining healthy weight, blood pressure and cholesterol levels. This reflects new medicines and technologies. They are also committed to closing racial disparities in diabetes care.
Diabetics are now advised to lose 5% to 15% of their weight, the previous recommendation. This change was made to reflect increased access to more effective weight loss medications.
They should also strive for blood pressure above 80 and below 130, an achievable target with blood pressure medications, and lower cholesterol levels, which is in line with the recommendations of the American College of Cardiology.
Diabetics with heart disease should seek LDL cholesterol levels between 100 and 70, the previous recommendation.
The Standards of Care are reviewed annually by the American Diabetes Association’s Professional Practices Committee.
ADA Chief Scientific and Medical Officer Robert Gabbay, Ph.D. “The ADA Standard of Care is the gold standard for diabetes care and prevention that keeps clinicians around the world abreast of the rapidly changing healthcare landscape.”
The guidelines emphasize the importance of getting enough quality sleep. Too much or too little can worsen diabetes outcomes. Physicians are called upon to advise their patients on proper sleep habits and to identify those who have sleep problems.
Physicians also recommend screening people with diabetes for social needs such as food insecurity and lack of access to fresh fruits and vegetables, factors that make it more difficult to manage people with diabetes properly. Physicians are being asked to recommend high-tech treatments such as automated insulin delivery devices and glucose pumps.
Racial disparities in diabetes outcomes
People of color are more likely to be diagnosed with diabetes, according to the Centers for Disease Control and Prevention. The same is true for people with lower incomes and lower education levels. And those gaps haven’t closed significantly in years, according to the CDC.
Earlier this year, a Lancet study found evidence of racial or ethnic disparities in the initiation of new diabetes drugs. This may contribute to worse health outcomes.
Black people with diabetes are almost four times more likely to have limb amputations than white people, and the disparity is getting worse each year. Improved screening for foot ulcers and peripheral arterial disease is needed to reduce this, according to new ADA guidelines. Both conditions can lead to disconnection.
Because people of color are less likely to have the same access to advanced technology, such as continuous glucose meters and new medicines, as white people, the guidelines now emphasize the need for universal access.
ADA CEO Chuck Henderson said: “This year’s annual report highlights the role health inequalities play in the development of diabetes, especially the role that vulnerable communities and communities of color play in diabetics. provides the guidance necessary to consider the disproportionate impact of the disease: “This guidance ensures that medical teams, clinicians, and researchers treat everyone.”
Leon Rock, co-founder of the African American Diabetes Association, told USA Today that the ADA is doing enough to address these disparities and support diabetes researchers at historically black colleges and universities. He said he was not providing any financial support.
Rock called ADA’s new steps to address these issues “starting,” but said, “Starting and doing are two different things.”
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