The American Diabetes Association® (ADA) and the European Association for the Study of Diabetes (EASD) announced today their new consensus update on management of hyperglycemia in type 2 diabetes.
The update has been prepared by an international committee of experts that include John B. Buse, MD, PhD, (University of North Carolina School of Medicine, Chapel Hill, NC); Melanie J. Davies, CBE, MBChB, MD, FRCP, FRCGP, FMedSciat (Leicester Diabetes Centre, Leicester, UK); and their colleagues. It updates the previous 2018 and 2019 consensus reports, and like its predecessors, this new document will be co-published in the ADA journal Diabetes Care and EASD’s journal Diabetologia.
“We are excited to share an updated consensus report on the management of hyperglycemia in type 2 diabetes,” said Dr. Robert Gabbay, chief scientific and medical officer for the ADA. “This is a wide-ranging consensus report that has several new features. It not only speaks of what needs to be done, but it also has a section on how to implement those changes.”
At ADA’s 82nd Scientific Sessions in June 2022, a draft version of the report was presented and the opportunity for feedback was provided. Among the suggested changes were more focus on person-centered care, equity of care, and managing weight loss. The committee reviewed the changes and the final report is now ready for publication.
The update provides guidance on improving equity of care and reviews how social determinants of health (SDOH) affect the management of hyerglycemia. It also focuses on the importance of weight loss and the use of evidence from randomized controlled trials on glucose-lowering medications to support evidence on weight loss/weight gain. As is in other ADA-EASD joint consensus reports, significant attention is given to the person’s involvement in their own diabetes care, including their home and economic circumstances, how they feel about the side effects of different possible medications and helping to choose their medication(s), and playing a full part in forming a regularly monitored care-management plan with their doctor.
Various recommendations on physical activity are included, including light exercise/resistance training every 30 minutes while sitting; an extra 500 daily steps; 150 minutes of moderate to vigorous physical activity each week; strength training two or three times per week; and getting between 6 and 9 hours of sleep each night.
Updates on glucose-lowering therapies are provided. These include recommendations on the use of oral GLP-1 receptor agonists (RAs), higher doses of dulaglutide and semaglutide, the GIP/GLP-1 RA class, and combination GLP-1 RA and insulin. Additionally, specific information on comorbid conditions (e.g., atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease) is described.
Finally, in the updated consensus report, many intersecting themes regarding person-centered care are covered. These include the language used discussing care with patients, shared decision-making, access to diabetes self-management education and support, considering the local care environment and the resources available, avoiding inertia in patient management plans, and the consideration of more aggressive and proactive treatment at initiation, such as the potential use of combination therapy immediately.
Prof John Buse (University of North Carolina School of Medicine, Chapel Hill, NC, USA) T) +1-919-923-6963 E) john_buse@med.unc.edu
Melanie Davies, Professor in Diabetes Medicine, Leicester Diabetes Centre, Leicester, UK T) +44 7590804182 E) melanie.davies@uhl-tr.nhs.uk
For the full report, click here.
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About the American Diabetes Association
The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 82 years, the ADA has driven discovery and research to treat, manage, and prevent diabetes while working relentlessly for a cure. Through advocacy, program development, and education we aim to improve the quality of life for the over 133 million Americans living with diabetes or prediabetes. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Spanish Facebook (Asociación Americana de la Diabetes), LinkedIn (American Diabetes Association), Twitter (@AmDiabetesAssn), and Instagram (@AmDiabetesAssn).
