Supportive evidence from well-conducted randomized controlled trials that are adequately powered, including:Įvidence from a well-conducted trial at one or more institutions The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.Ĭlear evidence from well-conducted, generalizable, randomized controlled trials that are adequately powered, including:Įvidence from a well-conducted multicenter trialĮvidence from a meta-analysis that incorporated quality ratings in the analysisĬompelling nonexperimental evidence, i.e., “all or none” rule developed by Center for Evidence Based Medicine at Oxford A grading system ( Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was used to clarify and codify the evidence that forms the basis for the recommendations. The recommendations included are screening, diagnostic, and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. For more detailed information about management of diabetes, refer to references 1 – 3. These standards are not intended to preclude clinical judgment or more extensive evaluation and management of the patient by other specialists as needed.
While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes.
Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. Diabetes is a chronic illness that requires continuing medical care and ongoing patient self-management education and support to prevent acute complications and to reduce the risk of long-term complications.
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