Diabetes Pro Quarterly - Spring 2022 - 11

Mission News
President's Corner
American Diabetes Association's Standards of Medical Care in Diabetes-2022
The American Diabetes Association's (ADA's)
annual Standards of Medical Care in Diabetes
guidelines include evidence-based clinical practice
recommendations on diabetes care and treatment
goals for clinicians, researchers, and other
professionals in the area of diabetes.
Following are 10 key recommendations from the
2022 Standards of Care.
1. Diabetes care should be individualized based
on the presence or absence of factors such as
atherosclerotic cardiovascular disease (ASCVD),
heart failure, chronic kidney disease (CKD),
hypoglycemia, and overweight/obesity.
2. The type 2 diabetes treatment algorithm no
longer mandates metformin as first-line therapy,
but rather indicates that treatments such as
glucagon-like peptide 1 (GLP-1) receptor
agonists and sodium-glucose cotransporter 2
(SGLT2) inhibitors may be acceptable alternatives
to metformin therapy for some people.
3. Screening for diabetes/prediabetes in all
asymptomatic adults should start at the age
of 35 years, and screening in adults with
overweight/obesity plus one or more risk factors
should start at 18 years of age.
4. Diabetes care providers are advised to provide
preconception counseling and to stress the
importance of achieving glucose levels as close
to normal as possible before conception. Earlypregnancy
diabetes screening of all women with
risk factors should occur at the first prenatal visit,
before 15 weeks of pregnancy.
5. People with diabetes should be screened for
CKD by measuring albuminuria with a spot
urinary albumin-to-creatinine ratio (UACR) and
by determining an estimated glomerular filtration
Guillermo E. Umpierrez, MD, CDCES, FACE, MACP
President, Medicine & Science
American Diabetes Association
Professor of Medicine
Emory University
Atlanta, GA
Email: geumpie@emory.edu
rate. Target a reduction in albuminuria of ≥30%
in those with CKD and a UACR ≥300 mg/mg.
6. SGLT2 inhibitors should be prescribed for all
people with diabetes and stage 3 or higher CKD
regardless of their glycemic control.
7. GLP-1 receptor agonists and SGLT2 inhibitors
are recommended for cardiovascular risk
reduction in people with type 2 diabetes and
CKD. The new mineralocorticoid receptor blocker
finerenone is also recommended in people with
albuminuria and diabetic kidney disease to
reduce CKD progression.
8. Early initiation of real-time or intermittently
scanned continuous glucose monitoring (CGM)
should occur at the outset of type 1 diabetes in
people who can use the devices safely. CGM
may be used in people with type 2 diabetes
who are taking multiple daily insulin injections,
on insulin pump therapy, or on a basal insulin
regimen and can use the devices safely.
9. Time in range (defined as 70-180 mg/dL
[3.9-10.0 mmol/L]) is identified as a useful
metric for glycemic control for most people with
diabetes, as it correlates well with A1C and with
the risk of microvascular complications.
10. Insulin pens are the preferred mode of insulin
administration over insulin vials and syringes.
The ADA's Standards of Care guidelines are
published annually in a supplement to Diabetes
Care. However, the Standards are considered a
" living " document, and important updates are
published more frequently online if new evidence
merits immediate revisions. The ADA offers a userfriendly
digital app that can be downloaded free of
charge from the App Store for iOS or from Google
Play for Android devices.
Otis Kirksey, PharmD, RPh, CDCES, BC-ADM
President, Health Care & Education
American Diabetes Association
Director of Pharmacy Services
Neighborhood Medical Center
Tallahassee, FL
Email: owkirksey@gmail.com
professional.diabetes.org 11

https://apps.apple.com/us/app/ada-standards-of-care/id529516990 https://play.google.com/store/apps/details?id=org.diabetes.american_diabetes_association_standards_of_medical_care https://play.google.com/store/apps/details?id=org.diabetes.american_diabetes_association_standards_of_medical_care http://professional.diabetes.org

Diabetes Pro Quarterly - Spring 2022

Table of Contents for the Digital Edition of Diabetes Pro Quarterly - Spring 2022