St. Mark's Hospital and St. Mark's Diabetes Center, Salt Lake City, Utah (J.J.C.).
University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota (E.L.J.).
Ann Intern Med. 2018 May 1;168(9):640-650. doi: 10.7326/M18-0222. Epub 2018 Apr 3.
The American Diabetes Association (ADA) annually updates its Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes.
For the 2018 standards, the ADA Professional Practice Committee searched MEDLINE through November 2017 to add, clarify, or revise recommendations on the basis of new evidence. The committee rated the recommendations as A, B, or C depending on the quality of evidence or E for expert consensus or clinical experience. The standards were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community informed revisions.
This synopsis focuses on guidance relating to cardiovascular disease and risk management in nonpregnant adults with diabetes. Recommendations address diagnosis and treatment of cardiovascular risk factors (hypertension and dyslipidemia), aspirin use, screening for and treatment of coronary heart disease, and lifestyle interventions.
美国糖尿病协会(ADA)每年都会更新其《糖尿病医疗护理标准》,为临床医生、患者、研究人员、支付方和其他感兴趣的各方提供基于证据的建议,用于诊断和管理糖尿病患者。
对于 2018 年的标准,ADA 专业实践委员会在 MEDLINE 上进行了搜索,截至 2017 年 11 月,根据新证据添加、澄清或修改了建议。委员会根据证据质量将建议评为 A、B 或 C,或根据专家共识或临床经验评为 E。该标准由 ADA 董事会执行委员会审查和批准,该委员会由医疗保健专业人员、科学家和非专业人员组成。更广泛的临床社区的反馈为修订提供了信息。
本概要重点介绍了与心血管疾病和非妊娠成年糖尿病患者的风险管理相关的指导。建议涉及心血管风险因素(高血压和血脂异常)的诊断和治疗、阿司匹林的使用、冠心病的筛查和治疗,以及生活方式干预。