The American Diabetes Association is pulling back the curtain on its annual updates to the ADA Standards of Care. Updated standards have been published every year since 1989, but this is the first year the ADA will showcase the people and processes that go into the revisions at the 82nd Scientific Sessions.
“There isn’t time to focus on all 17 areas in the Standards that were published in January, so we are showcasing one section: Prevention or delay of type 2 diabetes and Associated Comorbidities,” said Vanita R. Aroda, MD, Director of Diabetes Research at Brigham and Women’s Hospital and Associate Professor of Medicine at Harvard Medical School. “We will share how we work with new data that have been published recently to adjust the standards.”
Dr. Aroda and other members of the Professional Practice Committee will discuss the committee’s processes during ADA Standards of Care 2022 Spotlight—Prevention or Delay of Type 2 Diabetes and Associated Comorbidities at 12:45 p.m. CT on Friday, June 3, in Great Hall B at the convention center. The session will also be livestreamed for virtual meeting attendees.
“This session is about how diabetes care recommendations evolve from year to year as new treatments, opportunities, and data are available,” said Gretchen Benson, RDN, LDN, CDCES, Program Director, Women’s & Cardiovascular Health Science Centers, Minneapolis Heart Institute Foundation. “Updating the Standards of Care is a deliberate process that involves a multidisciplinary committee with expertise in a range of diabetes areas.”
Nearly all of the Standards of Care were revised for 2022, including recommendations for diabetes screening; diagnosis, prevention, evaluation, and management of comorbidities; patient education; technology and glycemic assessment; weight management; and care for special populations such as children and older people.
“Revised Standards of Care come out in January and we begin working on the next Standards in March,” said Florence M. Brown, MD, Senior Staff Physician at Joslin Diabetes Center and Co-Director of the Joslin-Beth Israel Deaconess Medical Center Diabetes in Pregnancy Program. “We all work on multiple sections because there’s such an overlap between, say, diabetes in pregnancy and prevention and delay of type 2 diabetes.”
The sheer volume of data can be daunting.
Prior to 2008, medications to lower blood glucose were approved by the U.S. Food and Drug Administration (FDA) based on small trials and with little long-term data. Early cardiovascular outcomes trials included 300 to 1,000 participants, while more recent studies incorporate information from more than 200,000 participants and millions of patient-years of evidence.
“As each of those studies comes down the pipe, we are bringing the data straight to the clinic both in the annual Standards of Care and in the ‘living’ Standards of Care that are published digitally every three to six months,” said ADA Past-President Jane Reusch, MD, Professor of Medicine, Bioengineering and Physiology at the University of Colorado Anschutz Medical Campus.
A single study, regardless of how dramatic the results, is not likely to change the Standards of Care, Dr. Reusch noted. But multiple studies supporting the same conclusions, such as the numerous trials of sodium-glucose cotransporter-2 inhibitors showing clear benefit in heart failure with or without diabetes, open the door to change.
“I love working on our Standards of Care because that’s where the rubber meets the road. At the end of the day, it’s about helping people living with diabetes. The way we do that is taking all of this fabulous medical research and putting into daily practice,” Dr. Reusch said.