Standards of Care in Diabetes—2023 Abridged for Primary Care Providers

The American Diabetes Association's (ADA's) Standards of Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes Care. The Standards of Care is developed by the ADA's multidisciplinary Professional Practice Committee, which comprises expert diabetes health care professionals (HCPs). It includes the most current evidence-based recommendations for diagnosing and treating adults and children with all forms of diabetes. ADA's grading system uses A, B, C, or E to show the evidence level that supports each recommendation. A-Clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered B-Supportive evidence from well-conducted cohort studies C-Supportive evidence from poorly controlled or uncontrolled studies E-Expert consensus or clinical experience This is an abridged version of the current Standards of Care containing the evidence-based recommendations most pertinent to primary care. The recommendations, tables, and figures included here retain the same numbering used in the complete Standards of Care. All of the recommendations included here are substantively the same as in the complete Standards of Care. The abridged version does not include references. The complete 2023 Standards of Care, including all supporting references, is available at professional. diabetes.org/standards. 1. IMPROVING CARE AND PROMOTING HEALTH IN POPULATIONS Diabetes and Population Health Person-centered care considers individual patient comorbidities and prognoses; is respectful of and responsive to patient preferences, needs, and values; and ensures that patient values guide all clinical decisions. Further, social determinants of health (SDOH)-often out of direct control of the individual and potentially representing lifelong risk-contribute to health care and psychosocial outcomes and must be addressed to improve all health outcomes. Recommendations 1.1 Ensure treatment decisions are timely, rely on evidence-based guidelines, include social community support, and are made collaboratively with patients based on individual preferences, prognoses, comorbidities, and informed financial considerations. B 1.2 Align approaches to diabetes management with the Chronic Care Model. This model emphasizes person-centered team care, integrated long-term treatment approaches to diabetes and comorbidities, and ongoing collaborative communication and goal-setting between all team members. A 1.3 Care systems should facilitate in-person and virtual team-based care, including those knowledgeable and experienced in diabetes management as part of the team and utilization of patient registries, decision support tools, and community involvement to meet patient needs. B Strategies for System-Level Improvement Care Teams Collaborative, multidisciplinary teams are best suited to provide care for people with diabetes and to facilitate patients' self-management with emphasis on avoiding therapeutic inertia to achieve recommended metabolic targets.

Telehealth

Telehealth may increase access to care for people with diabetes. Telehealth should be used complementary to in-person visits to optimize glycemic management in