ADA Issues New Standards of Medical Care for Diabetes

The American Diabetes Association has released its Standards of Medical Care in Diabetes - 2015. These standards are reviewed and updated each year to give providers the latest guidance for diagnosing and treating both type 1 and type 2 diabetes.

Cardiovascular Disease and Risk Management
The 2015 Standards include the following revisions to cardiovascular disease and risk management goals:

• Individuals with diabetes should be treated to a diastolic blood pressure (DBP) <90 mmHg. 
• Lower diastolic targets, such as <80 mmHg, may be appropriate for certain individuals, such as younger patients, if they can be achieved without undue treatment burden.
• People with diabetes and hypertension should be treated to a systolic blood pressure (SBP) goal of <140 mmHg.
• Lower systolic targets, such as < 130 mmHg, may be appropriate for certain individuals, such as younger patients, if they can be achieved without undue treatment burden. 

These revisions are in alignment with a recent publication by the Eight Joint National Committee that recommended, for individuals over 18 years of age with diabetes, a DBP threshold of <90 mmHg and SBP <140 mmHg.

Recommendations for statin treatment were also revised after consideration of 2013 American College of Cardiology/American Heart Association guidelines on the treatment of blood cholesterol. Treatment initiation (and initial statin dose) is now driven primarily by risk status rather than LDL cholesterol level. The recommendations for statin treatment in people with diabetes can be found below: