American Diabetes Association Releases 2023 Standards of Care in Diabetes

The American Diabetes Association (ADA) has released their updated Standards of Care for 2023 with the goal of providing the diabetes care team within an overview of diabetes management, including updates in diabetes technology, obesity, hypertension, heart failure medication, and lipid management.

The 2023 version of the living document, which has been updated annually since 1989, contains more than 100 updated recommendations within its 17 sections, with new updates highlighting the latest advances in clinical aspects of diabetes management, such as pharmacologic approaches to glycemic treatment, but also related to holistic diabetes management, including patient-first language and the influence of social determinants of health.

“ADA’s mission is to prevent and cure diabetes, a chronic illness that requires continuous medical care, and the release of ADA’s Standards of Care is a critical part of that mission,” said Chuck Henderson, chief executive officer for the ADA, in a statement from the ADA. “This year’s annual report provides necessary guidance that considers the role health inequities play in the development of diabetes, particularly for vulnerable communities and communities of color disproportionately impacted by the disease. This guidance will ensure health care teams, clinicians and researchers treat the whole person.”

Published on December 12, the document was prepared for multiple audiences, including primary care physicians, endocrinologists, nurse practitioners, physician associates, pharmacists, dietitians, and diabetes care and education specialists as well as cardiologists, nephrologists, emergency physicians, internists, pediatricians, psychologists, neurologists, ophthalmologists, and podiatrists. The document’s recommendations encompass care throughout the lifespan, including youth, adults, and older adults with diabetes, and cover the management of type 1 diabetes, type 2 diabetes, and gestational diabetes mellitus as well as other types of diabetes.

The updated Standards of Care in Diabetes—2023 also includes a 5-page summary of revisions. In this summary, the writing committee encapsulates relevant updates within the 17 sections of the document. Some of these revisions are highlighted below:

• Emphasis on supporting higher weight loss (up to 15%) based on the efficacy of and access to newer medications when appropriate
• New recommendations related to sleep health and physical activity in people with diabetes
• Broad consideration of social determinants of health in guiding the design and delivery of care
• New hypertension diagnosis cut-offs (hypertension is now defined as a systolic blood pressure at or exceeding 130 mmHg or a diastolic blood pressure ≥80 mmHg)
• The expanded role of SGLT2 inhibitor use in preserved and reduced heart failure ejection fraction
• The role of finerenone in individuals with diabetes and chronic kidney disease with albuminuria
• New lipid management recommendations suggesting lower LDL goals for high-risk individuals

The document was composed by a multidisciplinary team of 20 experts from the US, including physicians, nurse practitioners, certified diabetes care and education specialists, registered dietitians, pharmacists, methodologists, and others.

“Evidence-based recommendations drive better care for all people with diabetes, including vulnerable communities and those at high risk. ADA’s Standards of Care are the gold standard for diabetes care and prevention that allows clinicians around the world to remain abreast of the rapidly changing healthcare landscape,” said Robert Gabbay, MD, PhD chief scientific and medical officer for the ADA, in the aforementioned statement.

This document “Standards of Care in Diabetes—2023,” was published in Diabetes Care.