American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan—2022 Update

• Type of Material: Article
• Authors: Priyathama Vellanki, Emory University; Suchitra Chandrasekaran, Emory University; Lawrence Blonde, Ochsner Health; Guillermo Umpierrez, Emory University; Sethu S Reddy, Central Michigan University; Janet B McGill, Washington University in St. Louis; Sarah L Berga, University at Buffalo, The State University of New York; Michael Bush, Cedars-Sinai, Beverly Hills, California; Ralph A DeFronzo, The University of Texas at San Antonio; Daniel Einhorn, Whittier Institute for Diabetes; Rodolfo Galindo, Emory University; Thomas W Gardner, University of Michigan, Ann Arbor; Rajesh Garg, Harbor-UCLA Medical Center; Timothy W Garvey, The University of Alabama at Birmingham; Irl B Hirsch, University of Washington; Daniel L Hurley, Mayo Clinic, Rochester; Kenneth Izuora, University of Nevada, Las Vegas; Mikhail Kosiborod, Mid America Heart Institute - Kansas City; Darin Olson, Emory University; Shailendra B Patel, University of Cincinnati Medical Center; Rodica Pop-Busui, University of Michigan, Ann Arbor; Archana R Sadhu, Houston Methodist; Susan L Samson, Mayo Clinic in Jacksonville, Florida; Carla Stec, American Association of Clinical Endocrinology; William V Tamborlane, Yale School of Medicine; Katherine R Tuttle, University of Washington; Christine Twining, Maine Medical Center; Adrian Vella, Mayo Clinic, Rochester; Sandra L Weber, University of South Carolina School of Medicine Greenville
• Language: English
• Date: 2022-10-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 AACE. Published by Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.eprac.2022.08.002
• Title of Journal or Parent Work: Endocrine Practice
• Volume: 28
• Issue: 10
• Start Page: 923
• End Page: 1049
• Keywords: Dyslipidemias; United States; occupations; Insulin; prediabetic state; Hypoglycemic Agents; hypertension; diabetic neuropathies; diabetes mellitus, type 2; hypoglycemia; telemedicine; hospitalization; secondary diabetes; Humans; cardiovascular diseases; Endocrinology; antihyperglycemic medications; diabetic retinopathy; Pregnancy; diabetes; obesity; metabolic syndrome; diabetic nephropathies; pregnancy; vaccination; Female; dyslipidemias; sleep apnea syndromes; diabetes mellitus; atherosclerotic cardiovascular disease; Diabetes Mellitus, Type 2; gestational; infertility; diabetes mellitus, type 1; Child; guideline; interdisciplinary communication

Abstract

Objective: The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. Methods: The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. Results: This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. Conclusions: This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.