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Summary of Revisions for the 2013Clinical Practice Recommendations

Revisions to the Standardsof Medical Care inDiabetesd2013In addition to many small changes relatedto new evidence since the prior year, andto clarify recommendations, the follow-ing sections have undergone more sub-stantive changes:

c Section II.C. Screening for Type 1Diabetes has been revised to includemore specific recommendations.

c Section IV. Prevention/Delay of Type 2Diabetes has been revised to reflect

the importance of screening for andtreating other cardiovascular risk fac-tors.

c Section V.C.a. Glucose Monitoring hasbeen revised to highlight the need forpatients on intensive insulin regimensto do frequent self-monitoring of bloodglucose.

c Section V.D. Pharmacological andOverall Approaches to Treatment hasbeen revised to add a section with morespecific recommendations for insulintherapy in type 1 diabetes.

c

Section V.F. Diabetes Self-ManagementEducation and Support has been revisedto be consistent with the newly revised

National Standards for Diabetes Self-Management Education and Support.c Section V.K. Hypoglycemia has been

revised to emphasize the need to assesshypoglycemia and cognitive functionwhen indicated.

c Section V.M. Immunization has beenupdated to include the new Centers forDisease Control and Prevention (CDC)recommendations for hepatitis B vac-cination for people with diabetes.

c Section VI.A.1. Hypertension/BloodPressure Control has been revised tosuggest that the systolic blood pressure

goal for many people with diabetes andhypertension should be ,140 mmHg,but that lower systolic targets (such as,130 mmHg) may be appropriate forcertain individuals, such as youngerpatients, if it can be achieved withoutundue treatment burden.

c Section VI.A.2. Dyslipidemia/LipidManagement and Table 10 have beenrevised to emphasize the importance ofstatin therapy over particular LDLcholesterol goals in high-risk patients.

c Section VI.B. Nephropathy Screening

and Treatment and Table 11 have beenrevised to highlight increased urinaryalbumin excretion over the terms

micro- andmacroalbuminuria, other thanwhen discussion of past studies requiresthe distinction.

c Section VI.C. RetinopathyScreening andTreatment has been revised to includeantivascular endothelial growth factortherapy for diabetic macular edema.

c Section IX.A. Diabetes Care in theHospital has been revised to include arecommendation to consider obtainingan A1C in patients with risk factors forundiagnosed diabetes who exhibit hy-perglycemia in the hospital.

Revised Position Statementc The position statement Diagnosis and

Classification of Diabetes Mellitus hasbeen revised slightly to add newer in-formation about monogenic forms ofdiabetes.

Revisions to the NationalStandards for DiabetesSelf-Management Educationand Supportc The task force report National Standards

for Diabetes Self-Management Educationand Support represents a major revisioncompleted in 2012.

c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c c

DOI: 10.2337/dc13-S003 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly

cited,theuse iseducationaland notforprofit,and the workis notaltered.See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

care.diabetesjournals.org DIABETES CARE, VOLUME 36, SUPPLEMENT 1, JANUARY 2013 S3

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