Intensification of treatment for patients with type 2 diabetes not meeting treatment goals should not be delayed. 15.4 Insulin therapy should be initiated for treatment of persistent hyperglycemia starting at a threshold ≥ 180 mg/dL (10.0 mmol/L). B, 2.13 Risk-based screening for prediabetes and/or type 2 diabetes should be considered after the onset of puberty or after 10 years of age, whichever occurs earlier, in children and adolescents with overweight (BMI ≥85th percentile) or obesity (BMI ≥95th percentile) and who have additional risk factors for diabetes. If the patient has a test result near the margins of the diagnostic threshold, the provider should follow the patient closely and repeat the test in 3–6 months. This model emphasizes person-centered team care, integrated long-term treatment approaches to diabetes and comorbidities, and ongoing collaborative communication and goal setting between all team members. E, 10.40 In patients with known ASCVD, consider ACE inhibitor or ARB therapy to reduce the risk of CV events. C. Patients with or without diabetes may experience hypoglycemia in the hospital setting. A1C 7%553 mmol/mol. Microvascular Complications and Foot Care” in the complete 2020 Standards of Care. C, 14.22 A contraceptive plan should be discussed and implemented with all women with diabetes of reproductive potential. A, 11.11 Promptly refer to a physician experienced in the care of kidney disease for uncertainty about the etiology of kidney disease, difficult management issues, and rapidly progressing kidney disease. B, 2.7 Testing for prediabetes and/or type 2 diabetes in asymptomatic people should be considered in adults of any age with overweight or obesity (BMI ≥25 kg/m2 or ≥23 kg/m2 in Asian Americans) and who have one or more additional risk factors for diabetes (Table 2.3). **Thiazide-like diuretic; long-acting agents shown to reduce CV events, such as chlorthalidone and indapamide, are preferred. Institutional Subscriptions and Site Licenses, Special Podcast Series: Therapeutic Inertia, Special Podcast Series: Influenza Podcasts, “4. 5.27 All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior. B, 14.5 In addition to focused attention on achieving glycemic targets A, standard preconception care should be augmented with extra focus on nutrition, diabetes education, and screening for diabetes comorbidities and complications. B, 11.26 Assessment for distal symmetric polyneuropathy should include a careful history and assessment of either temperature or pinprick sensation (small fiber function) and vibration sensation using a 128-Hz tuning fork (for large-fiber function). B, 10.14 Patients with hypertension who are not meeting blood pressure targets on three classes of antihypertensive medications (including a diuretic) should be considered for mineralocorticoid receptor antagonist therapy. Diabetes Care 19 December 2019 [Epub ahead of print]. B, 11.17 Programs that use retinal photography (with remote reading or use of a validated assessment tool) to improve access to diabetic retinopathy screening can be appropriate screening strategies for diabetic retinopathy. A. A An insulin regimen with basal, prandial, and correction components is the preferred treatment for noncritically ill hospitalized patients with good nutritional intake. B, 11.27 Symptoms and signs of autonomic neuropathy should be assessed in patients with microvascular complications. E, 10.18 Obtain a lipid profile at initiation of statins or other lipid-lowering therapy, 4–12 weeks after initiation or a change in dose, and annually thereafter as it may help to monitor the response to therapy and inform medication adherence. B. Diabetes technology describes the devices, software, and hardware used to manage diabetes. Models such as these are potentially important and, once validated for general use, could provide a valuable tool to reduce rates of hypoglycemia in hospitalized patients. The American Diabetes Association’s (ADA’s) Standards of Medical Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes Care. Diabetes confers an increase maternal and fetal risk. 14.1 Starting at puberty and continuing in all women with diabetes and reproductive potential, preconception counseling should be incorporated into routine diabetes care. C. Initial orders should state the type of diabetes. Metformin is the first-line agent for older adults with type 2 diabetes. Metformin is the preferred initial pharmacologic agent for the treatment of type 2 diabetes. C, 11.2 Optimize glucose control to reduce the risk or slow the progression of CKD. Inhibitor or ARB therapy to reduce risks of medications should initiate conversations regarding the goals of treatment for glycemic and! Treating adults and should be avoided a contraceptive plan should be queried as. Provide details for informed decision-making on pharmacologic agents for type 2 diabetes, ada diabetes guidelines 2020 2–3 sessions/week resistance! Target levels is indicated in most instances in the complete 2020 Standards of care,... 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