- Health technology and diabetes management: The ADA recommends the delivery of effective diabetes self-management education and support. Also, the ADA has recommendations on using continuous glucose monitoring (CGM) technology to improve glycemic control in adults with type 1 diabetes starting at age 18. More information on CGM devices are presented in a later section of this course.
- A1C test considerations: Additional information and recommendations have been added to help ensure appropriate use of the A1C test to diagnose diabetes and for monitoring glycemic control in people with diabetes. The ADA stresses that the A1C test can give skewed results in people with certain genetic traits that alter the molecules in their red blood cells. Moreover, the ADA emphasizes that health care providers need to be aware of these limitations, to use the correct type of A1C test, and to consider alternate diagnostic tests (fasting plasma glucose test or oral glucose tolerance test) if there is disagreement between A1C and blood glucose levels.
- Diabetes management in specific groups: A new guideline recommends all pregnant women with pre-existing type 1 or type 2 diabetes should consider daily low-dose aspirin starting at the end of the first trimester in order to reduce the risk of pre-eclampsia.
- Patient-centered care and acknowledging cost-of-care impact: Information is presented to summarize drug-specific and patient factors that may impact diabetes treatment. The most relevant considerations are the risks of hypoglycemia, weight effects, kidney effects and costs for all preferred diabetes medications.
- Other Important updates: The immunization needs for people with diabetes were clarified and updated. Also, there are discussions on emerging evidence that specific glucose-lowering medications delay the onset and progression of kidney disease.
Note: For more details on the ADA’s updated 2018 guidelines, please consult the following link:
http://diabetesed.net/wp-content/uploads/2017/12/2018-ADA-Standards-of-Care.pdf. Accessed April 22, 2020.
