Diabetes Pro Quarterly - Winter 2022 - 3

Cover Story: 2022 Standards of Care
continued from page 1
Highlights from the 2022 Standards of Care
Some notable updates and additions include:
* Guidance on first-line therapy determined by
comorbidities
* Screening for prediabetes and diabetes
beginning at age 35 for all people
* Changes to gestational diabetes mellitus (GDM)
recommendations regarding when to test and in
whom testing should be done
* Updated recommendations on technology
selection based on individual and caregiver
considerations, ongoing education on the use
of devices, continued access to devices across
payers, support of students using devices in
school settings, use of telehealth visits, and early
initiation of technology
Other noteworthy updates and additions to this
year's Standards of Care include:
Diabetes Screening
* Rrecommendations about adequate
carbohydrate intake before oral glucose
tolerance testing as a screen for diabetes were
added (Recommendations 2.4 and 2.12).
* The discussion regarding use of point-of-care
A1C assays for the diagnosis of diabetes has
been revised.
* Recommendation 2.24 regarding genetic
testing for individuals who do not have typical
characteristics of type 1 or type 2 diabetes has
been revised based on the recent publication
of " The Management of Type 1 Diabetes in
Adults: A Consensus Report by the American
Diabetes Association (ADA) and the European
Association for the Study of Diabetes (EASD). "
Pregnancy
* The GDM recommendations have been revised
regarding when to test and in whom testing
should be done, with supporting evidence
added to the text.
* Recommendation 15.16 and its related
discussion includes the evidence on the value of
telehealth visits for pregnant women with GDM.
* A new subsection on physical activity during
pregnancy for women with diabetes has
been added.
* Additional discussion was added regarding
insulin as the preferred treatment for type 2
diabetes in pregnancy.
Technology
* General recommendations on the selection
of technology based on individual and
caregiver preferences (Recommendation 7.1),
ongoing education on the use of devices
(Recommendation 7.2), continued access to
devices across payers (Recommendation 7.3),
support of students using devices in school
settings (Recommendation 7.4), and early
initiation of technology (Recommendation 7.5)
now introduce the technology section, whereas
previously these concepts were distributed
throughout the section.
* The term " self-monitoring of blood glucose "
was replaced with the more commonly used
" blood glucose monitoring " (BGM) throughout
the guidelines, and more information based
on the U.S. Food and Drug Administration
recommendation regarding when an individual
might need access to BGM was added to the
BGM subsection.
* Recommendations regarding use of continuous
glucose monitoring (CGM) were divided
between adults (Recommendations 7.11 and
7.12) and youth (Recommendations 7.13 and
7.14), and the recommendation regarding
periodic use of CGM or the use of professional
CGM has been simplified (Recommendation
7.17). Frequency of sensor use has also been
added to the text of the subsection on CGM,
which has been reorganized to summarize the
evidence according to study design.
* " Smart pens " are now referred to as " connected
insulin pens, " and more discussion and evidence
has been added to the content on these devices.
The ADA also publishes the Standards of Medical
Care in Diabetes Abridged for Primary Care
Providers yearly online and in Clinical Diabetes
and offers a convenient Standards of Care app as
well as a Standards of Care Pocket Chart. Other
Standards of Care resources, including a webcast
with continuing education credit and a full slide
deck, can be found on our Practice Guidelines
Resources page on the DiabetesPro website.
professional.diabetes.org 3
Diabetes Pro Quarterly - Winter 2022

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