By V. Scantlebury, MD, FACS, DPC Education Center Healthcare Consultant
The American Diabetes Association has recently made more aggressive changes to the Standard of Care in Diabetes -2023. Published in December 2022 as a supplement in Diabetes Care, this document is considered the gold standard for the care of over 100 million Americans living with diabetes and pre-diabetes.
Below is a summary of some of the recommendations:
A blood pressure target for people with diabetes of less than 130/80 mmHg, if it can be reached safely. Blood pressure targets should be individualized through a shared decision-making process that addresses the risks of cardiovascular disease and the potential adverse effects of antihypertensive medications and patient preferences.
Intensify lifestyle modifications and optimize glycemic control in patients with triglycerides > 150 mg/dl or a low-density lipoprotein (LDL) cholesterol less than 70 mg/dL or less than 55 mg/dL, depending on your risks of heart disease (LDL is the bad cholesterol). For diabetic patients ages, 40-75 with risk factors for arterial plaque disease, high-intensity statin treatments should be used to decrease LDL by 50% from baseline values.
The addition of newer glucose-lowering medications that are beneficial in patients with chronic kidney disease, who are at risk for worsening kidney function.
An emphasis on weight loss as a goal: A 15% reduction from baseline is recommended, with or without the use of FDA-approved medications that have weight loss potential while lowering your blood sugar.
Screening and assessing for peripheral artery disease in an effort to prevent amputations in those patients with progressive narrowing of blood vessels to the feet and toes.
These recommendations are to decrease the risk of complications from long-term diabetes, and so we advise that you discuss these recommendations with your doctor.