Diabetes Management Algorithm from the American Assocaition of Clinical Endocrinologists
A new algorithm to guide primary care physicians, endocrinologists, and other health care professionals in the treatment of patients with prediabetes and type 2 diabetes mellitus
The document addresses:
• Management of diabetes and co-existing disorders in the prediabetic phase of disease.
• A hierarchy of steps for blood sugar control, using an approach that balances age and comorbidities while minimizing the adverse effects of hypoglycemia and weight gain.
• Complications-centric treatment of the overweight or obese patient, including treatments to promote weight loss.
• Management of cardiovascular disease risk factors, hypertension, and hyperlipidemia in patients with prediabetes or T2DM.
The algorithm recommends that comprehensive care plans for persons with diabetes consider obesity management as an integral part of the overall treatment plan. Also, while suggesting a blood sugar goal of less than 6.5% A1c as optimal for most diabetes patients if it can be achieved in a safe manner, the algorithm recommends that this target be individualized based on factors such as age, comorbid conditions, duration of diabetes, risk of hypoglycemia, and patient motivation and adherence. The algorithm includes every FDA-approved class of medications for diabetes and differentiates the choice of therapies based on the patient's initial A1C.
Source: AACE Comprehensive Diabetes Management Algorithm 2013. Endocrine Practice. Vol 19 No. 2 March/April 2013; 327-336.