Wednesday, December 28, 2016

Essentials from the 2016 American Diabetes Association guidelines

The 2016 American Diabetes Association diabetes guidelines is a lengthy document outlining many aspects of diabetes care including evaluation, diagnosis, prevention, management of glycemia, and management of nonglycemic issues.  Here are some of the more common elements that come up in the internal medicine setting regarding glycemic control.

Criteria for the diagnosis of diabetes:

  1. Fasting plasma glucose ≥126 mg/dL (fasting means no caloric intake for 8 hours)
  2. 2 hr plasma glucose ≥200 mg/dL during an OGTT (oral glucose tolerance test) – the test involves drinking 75 g anhydrous glucose dissolved in water
  3. A1C ≥6.5%
  4. Random plasma glucose ≥200 mg/dL plus classic symptoms of hyperglycemia – ie. polydipsia, polyuria, weight loss
*If these results are somewhat close to the diagnostic threshold, a repeat test is recommended

Glycemic goals:

  • A1C <7%
  • Preprandial plasma glucose 80-130 mg/dL
  • Peak postprandial plasma glucose <180 mg/dL (1-2 hours after beginning of meal)
*Goals should be individualized based on individual characteristics and comorbidities

Potency of antihyperglycemics and recommendations for use:

  • Start with metformin therapy and continue metformin as additional agents added (including insulin)
    • As long as no contraindications present
  • Each noninsulin agent added lowers A1C by 0.9-1.1%
  • Insulins have theoretically unlimited efficacy
  • Consider combination noninsulin agents if A1C ≥9%
  • Consider combination insulin therapy if A1C ≥10-12%

American Diabetes Association. Standards of medical care in diabetes – 2016.  Diabetes Care  2016;39(Suppl. 1):S1-112.

image from wikimedia commons


  1. Start for your diabetic supply subscription and get top quality diabetic testing supplies shipped free to your door every 90 days, Get diabetic testing supplies online. 
    diabetic supplies companies

  2. Many people choose to avoid the risks associated with medications. There are natural treatments for diabetes. diabetes diet

  3. You know your projects stand out of the herd. There is something special about them. It seems to me all of them are really brilliant! ask the doctor online

  4. Small foot problems for diabetics can be magnified due to their hyposensitivity or lack of feeling.

  5. This is very educational content and written well for a change. It's nice to see that some people still understand how to write a quality post.! diabetes insipidus

  6. This is wonderful! Thank you for taking time to share the professional article.
    Whatever treatment you choose either medications or natural one, changing your life style for the better.


  7. Diabetes can cause serious health problems, such as heart disease, stroke, and eye and foot problems. Prediabetes also can cause health problems. The good news is that type 2 diabetes can be delayed or even prevented. The longer you have diabetes, the more likely you are to develop health problems, so delaying diabetes by even a few years will benefit your health. You can help prevent or delay type 2 diabetes by losing a modest amount of weight by following a reduced-calorie eating plan and being physically active most days of the week. Ask your doctor if you should take the diabetes drug metformin to help prevent or delay type 2 diabetes.destructeur diabète and Maitrisez Votre Diabete


Note: Only a member of this blog may post a comment.

Recommended for you