会议预告

临床指南

ADA:2011年糖尿病的医疗标准

2011年糖尿病的医疗标准

Standards of Medical Care in Diabetes—2011

CONTENTS

 

I. CLASSIFICATION AND DIAGNOSIS OF DIABETES, p. S12
A. Classification of diabetes
B. Diagnosis of diabetes
C. Categories of increased risk for diabetes(prediabetes)
II. TESTING FOR DIABETES IN ASYMPTOMATIC PATIENTS, p. S13
A. Testing for type 2 diabetes and risk of future diabetes in adults
B. Testing for type 2 diabetes in children
C. Screening for type 1 diabetes
III. DETECTION AND DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS,p. S15
IV. PREVENTION/DELAY OF TYPE 2 DIABETES, p. S16
V. DIABETES CARE, p. S16
A. Initial evaluation
B. Management
C. Glycemic control
1. Assessment of glycemic control
a. Glucose monitoring
b. A1C
2. Glycemic goals in adults
D. Pharmacologic and overall approaches to treatment
1. Therapy for type 1 diabetes
2. Therapy for type 2 diabetes
E. Diabetes self-management education
F. Medical nutrition therapy
G. Physical activity
H. Psychosocial assessment and care
I. When treatment goals are not met
J. Hypoglycemia
K. Intercurrent illness
L. Bariatric surgery
M. Immunization
VI. PREVENTION AND MANAGEMENT OF DIABETES COMPLICATIONS, p.S27
A. Cardiovascular disease
1. Hypertension/blood pressure control
2. Dyslipidemia/lipid management
3. Antiplatelet agents
4. Smoking cessation
5. Coronary heart disease screening and treatment
B. Nephropathy screening and treatment
C. Retinopathy screening and treatment
D. Neuropathy screening and treatment
E. Foot care
VII. DIABETES CARE IN SPECIFIC POPULATIONS,p. S38
A. Children and adolescents
1. Type 1 diabetes Glycemic control
a. Screening and management of chronic complications in children and adolescents with type 1 diabetes
i. Nephropathy
ii. Hypertension
iii. Dyslipidemia
iv. Retinopathy
v. Celiac disease
vi. Hypothyroidism
b. Self-management
c. School and day care
d. Transition from pediatric to adult care
2. Type 2 diabetes
3. Monogenic diabetes syndromes
B. Preconception care
C. Older adults
D. Cystic fibrosis–related diabetes
VIII. DIABETES CARE IN SPECIFIC SETTINGS, p. S43
A. Diabetes care in the hospital
1. Glycemic targets in hospitalized patients
2. Anti-hyperglycemic agents in hospitalized patients
3. Preventing hypoglycemia
4. Diabetes care providers in the hospital
5. Self-management in the hospital
6. Diabetes self-management education in the hospital
7. Medical nutrition therapy in the hospital
8. Bedside blood glucose monitoring
9. Discharge planning
IX. STRATEGIES FOR IMPROVING DIABETES CARE, p. S46
 
     Diabetes is a chronic illness that requirescontinuing medical care andongoing patient self-managementeducation and support to prevent acutecomplications and to reduce the risk oflong-term complications. Diabetes care iscomplex and requires that many issues,beyond glycemic control, be addressed. Alarge body of evidence exists that supportsa range of interventions to improvediabetes outcomes.
     
     These standards of care are intendedto provide clinicians, patients, researchers,payors, and other interested individualswith the components of diabetescare, general treatment goals, and tools toevaluate the quality of care. While individualpreferences, comorbidities, andother patient factors may require modificationof goals, targets that are desirablefor most patients with diabetes are provided.These standards are not intendedto preclude clinical judgment or more extensiveevaluation and management of thepatient by other specialists as needed.For more detailed information aboutmanagement of diabetes, refer to references1–3.
     
      The recommendations included arescreening, diagnostic, and therapeutic actionsthat are known or believed to favorablyaffect health outcomes of patientswith diabetes. A grading system (Table 1),developed by the American Diabetes Association(ADA) and modeled after existingmethods, was utilized to clarify andcodify the evidence that forms the basisfor the recommendations. The level of evidencethat supports each recommenda-tion is listed after each recommendationusing the letters A, B, C, or E.
     
      These standards of care are revisedannually by the ADA’s multidisciplinaryProfessional Practice Committee, incorporatingnew evidence. Members of theProfessional Practice Committee and theirdisclosed conflicts of interest are listed onpage S97. Subsequently, as with all PositionStatements, the standards of care arereviewed and approved by the ExecutiveCommittee of ADA’s Board of Directors.
 
求助文献
本网站部分资源来源于网络,版权归原作者所有,转载仅作交流。如有版权问题请联系help.basalinsulin@gmail.com,我们将及时处理。
全文检索小助手:

如果您有“基础胰岛素相关文献全文”的检索需求,敬请联系help.basalinsulin@gmail.com,我们将为您搜索并发送到您的邮箱内! 请在“全文求助”邮件内尽量详细说明“标题、作者、杂志及卷期、PMID、全文链接”等内容,以便我们更精准地进行搜索!

求助全文

最新评论 暂无评论

不能超过250字,需审核,请自觉遵守互联网相关政策法规