Top Ten Things Every Clinician Should Know about the 2022 Standard for Medical Care for Diabetes

Authors:
Jennifer N. Clements, PharmD, BCPS, BCACP, CDCES, BC-ADM

Reviewers:
Joshua Neumiller, PharmD, CDCES
Kristi W. Kelley, Pharm.D., BCPS, BCACP, CDCES, BC-ADM

Citation:
American Diabetes Association Professional Practice Committee. Standard of Medical Care in Diabetes – 2022. Diabetes Care 2022;45(Suppl 1): S1-S264.

Introduction

Published in Diabetes Care every January, the Standards of Medical Care in Diabetes by the American Diabetes Association (ADA) provides recommendations for the care of patients with diabetes.  And every year clinicians eagerly read, discuss, and apply them in their practices.  The document has been released annually for the past 25 years and contains clear recommendations intended to improve health outcomes for people with diabetes. In 2018, the Standards became “Living Standards” that include notable updates about medication and clinical trials throughout the year. In the 2022 Standards, the clinical practice guidelines were written by physicians, nurses, dieticians, pharmacists, and other healthcare professionals, many of whom are diabetes care and education specialists. Two cardiologists from the American College of Cardiology (ACC) served as representatives for the section on cardiovascular disease and risk management (Section 10), which lead to an endorsement by ACC.

In the standards, Level A recommendations are ones that are backed up by clear, compelling, and supportive evidence from randomized, controlled trials.  Level B recommendations are based on supportive evidence from rigorous cohort studies and Level C recommendations are based on conflicting evidence or poorly controlled/uncontrolled studies.  Level E recommendations are based on expert consensus or clinical experience. Standards 2022 is a 264-page document!  It’s lengthy!  But you can find a summary of key points in the Abridged Standards of Care For Primary Care Providers and Summary of Revisions. A webcast is available that highlights some of the key changes in the standards and an app may be useful as a quick reference when needed.

This commentary reviews the top ten things every clinician should know about the 2022 Standards of Medical Care in Diabetes.  This list is in no specific order of importance and is intended to describe the most relevant changes for ambulatory care practitioners.