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

Lawrence Blonde, Guillermo E. Umpierrez, S. Sethu Reddy, Janet B. McGill, Sarah L. Berga, Michael Bush, Suchitra Chandrasekaran, Ralph A. DeFronzo, Daniel Einhorn, Rodolfo J. Galindo, Thomas W. Gardner, Rajesh Garg, W. Timothy Garvey, Irl B. Hirsch, Daniel L. Hurley, Kenneth Izuora, Mikhail Kosiborod, Darin Olson, Shailendra B. Patel, Rodica Pop-BusuiArchana R. Sadhu, Susan L. Samson, Carla Stec, William V. Tamborlane, Katherine R. Tuttle, Christine Twining, Adrian Vella, Priyathama Vellanki, Sandra L. Weber

Research output: Contribution to journalArticlepeer-review

234 Scopus citations

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.

Original languageEnglish
Pages (from-to)923-1049
Number of pages127
JournalEndocrine Practice
Volume28
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • antihyperglycemic medications
  • atherosclerotic cardiovascular disease
  • cardiovascular diseases
  • diabetes
  • diabetes mellitus
  • diabetes mellitus, type 1
  • diabetes mellitus, type 2
  • diabetic nephropathies
  • diabetic neuropathies
  • diabetic retinopathy
  • dyslipidemias
  • gestational
  • guideline
  • hospitalization
  • hypertension
  • hypoglycemia
  • infertility
  • interdisciplinary communication
  • metabolic syndrome
  • obesity
  • occupations
  • prediabetic state
  • pregnancy
  • secondary diabetes
  • sleep apnea syndromes
  • telemedicine
  • vaccination

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