Diabetes Self-Management, Education, and Support: Difference between revisions

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==2016 ADA Standards of Medical Care in Diabetes Guidelines==
==2016 ADA Standards of Medical Care in Diabetes Guidelines==
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''1.''' Consider performing an A1C on all patients with diabetes or hyperglycemia admitted to the hospital if not performed in the prior 3 months. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki>
| bgcolor="Seashell" |<nowiki>"</nowiki>'''1.'''In accordance with the national standards for diabetes self-management education (DSME) and support (DSMS), all people with diabetes should participate in DSME to facilitate the knowledge, skills, and ability necessary for diabetes self-care and in DSMS to assist with implementing and sustaining skills and behaviors needed for ongoing self-management, both at diagnosis and as needed thereafter ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''2.''' Insulin therapy should be initiated for treatment of persistent hyperglycemia starting at a threshold ≥180 mg/dL (10.0 mmol/L). Once insulin therapy is started, a target glucose range of 140–180 mg/dL (7.8–10.0 mmol/L) is recommended for the majority of critically ill patients''([[American Diabetes Association#Evidence Grading System|Level of Evidence: A]])''and noncritically ill patients ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki>
| bgcolor="Seashell" |<nowiki>"</nowiki>'''2.'''Effective self-management, improved clinical outcomes, health status, and quality of life are key outcomes of DSME and DSMS and should be measured and monitored as part of care ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''3.''' More stringent goals, such as 110–140 mg/dL (6.1–7.8 mmol/L) may be ap- propriate for selected critically ill patients, as long as this can be achieved without significant hypoglycemia ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki>
| bgcolor="Seashell" |<nowiki>"</nowiki>'''3.'''DSME and DSMS should be patient centered, respectful, and responsive to individual patient preferences, needs, and values, which should guide clinical decisions ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: A]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''4.''' Intravenous insulin infusions should be administered using validated written or computerized protocols that allow for predefined adjustments in the insulin infusion rate based on glycemic fluctuations and insulin dose. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki>
| bgcolor="Seashell" |<nowiki>"</nowiki>'''4.''' DSME and DSMS programs should have the necessary elements in their curricula that are needed to prevent the onset of diabetes. DSME and DSMS programs should therefore tailor their content specifically when prevention of diabetes is the desired goal ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''5.''' A basal plus bolus correction insulin regimen is the preferred treatment for noncritically ill patients with poor oral intake or those who are taking nothing by mouth. An insulin regimen with basal, nutritional, and correction components is the preferred treatment for patients with good nutritional intake. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: A]])''<nowiki>"</nowiki>
| bgcolor="Seashell" |<nowiki>"</nowiki>'''5.''' Because DSME and DSMS can result in cost savings and improved outcomes ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])'', DSME and DSMS should be adequately reimbursed by third-party payers ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''6.''' The sole use of sliding scale insulin in the inpatient hospital setting is strongly discouraged ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: A]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''7.''' A hypoglycemia management protocol should be adopted and implemented by each hospital or hospital system. A plan for preventing and treating hypoglycemia should be established for each patient. Episodes of hypoglycemia in the hospital should be documented in the medical record and tracked. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: E]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''8.''' The treatment regimen should be reviewed and changed if necessary to prevent further hypoglycemia when a blood glucose value is <70 mg/dL (3.9 mmol/L). ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: C]])''<nowiki>"</nowiki>
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| bgcolor="Seashell" |<nowiki>"</nowiki>'''9.''' There should be a structured discharge plan tailored to the individual patient. ''([[American Diabetes Association#Evidence Grading System|Level of Evidence: B]])''<nowiki>"</nowiki>
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==References==
==References==
{{Reflist|2}}{{WH}}{{WS}}
{{Reflist|2}}{{WH}}{{WS}}

Revision as of 18:52, 7 December 2016

2016 ADA Guideline Recommendations

Types of Diabetes Mellitus

Main Diabetes Page

Diabetes type I

Diabetes type II

Gestational Diabetes Mellitus

2016 ADA Standard of Medical Care Guideline Recommendations

Strategies for Improving Care

Classification and Diagnosis of Diabetes

Foundations of Care and Comprehensive Medical Evaluation

Diabetes Self-Management, Education, and Support
Nutritional Therapy

Prevention or Delay of Type II Diabetes

Glycemic Targets

Obesity Management for Treatment of Type II Diabetes

Approaches to Glycemic Treatment

Cardiovascular Disease and Risk Management

Hypertension and Blood Pressure Control
Lipid Management
Antiplatelet Agents
Coronary Heart Disease

Microvascular Complications and Foot Care

Diabetic Kidney Disease
Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Footcare

Older Adults with Diabetes

Children and Adolescents with Diabetes

Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes
Microvascular Complications in Children and Adolescents with Diabetes

Management of Diabetes in Pregnancy

Diabetes Care in the Hospital Setting

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]; Seyedmahdi Pahlavani, M.D. [3]; Tarek Nafee, M.D. [4]

2016 ADA Standards of Medical Care in Diabetes Guidelines

"1.In accordance with the national standards for diabetes self-management education (DSME) and support (DSMS), all people with diabetes should participate in DSME to facilitate the knowledge, skills, and ability necessary for diabetes self-care and in DSMS to assist with implementing and sustaining skills and behaviors needed for ongoing self-management, both at diagnosis and as needed thereafter (Level of Evidence: B)"
"2.Effective self-management, improved clinical outcomes, health status, and quality of life are key outcomes of DSME and DSMS and should be measured and monitored as part of care (Level of Evidence: C)"
"3.DSME and DSMS should be patient centered, respectful, and responsive to individual patient preferences, needs, and values, which should guide clinical decisions (Level of Evidence: A)"
"4. DSME and DSMS programs should have the necessary elements in their curricula that are needed to prevent the onset of diabetes. DSME and DSMS programs should therefore tailor their content specifically when prevention of diabetes is the desired goal (Level of Evidence: B)"
"5. Because DSME and DSMS can result in cost savings and improved outcomes (Level of Evidence: B), DSME and DSMS should be adequately reimbursed by third-party payers (Level of Evidence: E)"

References

Template:WHTemplate:WS

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