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ManagementofType2DiabetesMellitus
Guidelines for Clinical Care Ambulatory
Diabetes Mellitus Guideline Team
Management of Type 2 Diabetes Mellitus
Team Leaders
Connie J Standiford, MD General Internal Medicine Sandeep Vijan, MD General Internal Medicine
Team Members
Patient population. Adults Objectives. To reduce morbidity and mortality by improving adherence to important
recommendations for preventing, detecting, and managing diabetic complications.
Key points
Hae Mi Choe, PharmD College of Pharmacy
R Van Harrison, PhD Medical Education
Caroline R Richardson, MD Family Medicine
Prevention. In individuals at risk for type 2 diabetes (see Table 1), type 2 diabetes can be delayed or prevented through diet, exercise, and pharmacologic interventions [IA].
Screening. Although little evidence is available on screening for diabetes, screening should be considered every 3 years beginning at age 45 or annually at any age if BMI ≥ 25 kg/m2 [evidence: IID], history of hypertension [IIB], gestational diabetes [IC], or other risk factors.
Jennifer A Wyckoff, MD Diagnosis. An A1c of 6.5% or greater, confirmed by second test, is diagnostic of diabetes. Alternatively,
Metabolism, Endocrinology Diabetes
diabetes can be diagnosed by two separate fasting glucoses ≥ 126 mg/dL; with symptoms, a glucose ≥ 200 mg/dL confirmed on a separate day by a fasting glucose ≥ 126 mg/dL; or 2-hour postload glucose ≥
Consultants
200 mg/dl during an oral glucose tolerance test [B]. (See Table 1. See Table 2 for differential diagnosis.)
Martha M Funnell, MS, RN,
CDE Treatment. Essential components of the treatment for diabetes include diabetes self-management education
Diabetes Research and Training Center
William H Herman, MD Metabolism, Endocrine
and support, lifestyle interventions, and goal setting (see Table 3); glycemic management (see Tables 410); and pharmacologic management of hypertension (see Table 11) and hyperlipidemia.
Screening for comorbidities and complications. Routine screening and prompt treatment for
Diabetes
car
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