ADA Clinical Practice Guidelines

American Diabetes Association. Diabetes Care. 2005;28(suppl 1):S1-S79.

An updated version of the American Diabetes Association’s (ADA’s) Clinical Practice Guidelines has been published in the January supplement to Diabetes Care. The guidelines have been revised to reflect new study results as well as reorganized; rather than consisting of all ADA position statements, only select ones have been included.

The position statement "Standards of Medical Care in Diabetes" has been included to emphasize the importance of standards in the treatment of diabetes. All key recommendations are now listed in this section. Additional position statements not adequately covered in the section on standards of care are also included as part of the 2005 guidelines (diagnosis and classification of diabetes mellitus; diabetes care in the school and day care setting; diabetes care at diabetes camps; diabetes management in correctional institutions; hypoglycemia and employment/licensure; and third-party reimbursement for diabetes care, self-management education, and supplies).

Major revisions include updated information about medical nutrition therapy and lipid management. The ADA does not recommend a low carbohydrate diet for patients with diabetes. Carbohydrates should make up 45% to 65% of daily caloric intake as they are an important source of energy, fiber, and water-soluble vitamins and minerals. The importance of lifestyle changes in the prevention and management of obesity are also emphasized. Information on lipid management has been updated to reflect findings of recent trials and include those recommendations listed in Table 1.

Table 1. Lipid management in patients with diabetes

CVD, cardiovascular disease; LDL, low-density lipoprotein

Position statements not included in the 2005 guidelines will be revised and published as necessary.