Standards of Medical Care in Diabetes—2021 Abridged for Primary Care Providers

Euglycemic Diabetic Ketoacidosis in a Patient Prescribed Empagliflozin and a Ketogenic Diet: A Case of Misdiagnosed Type 1 Diabetes

The American Diabetes Association (ADA) Standards of Medical Care in Diabetes is updated and published annually in a supplement to the January issue of Diabetes Care. The Standards are developed by the ADA’s multidisciplinary Professional Practice Committee, which comprises physicians, diabetes educators, and other expert diabetes health care professionals. The Standards include 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 poweredB—Supportive evidence from well-conducted cohort studiesC—Supportive evidence from poorly controlled or uncontrolled studiesE—Expert consensus or clinical experienceThis is an abridged version of the current Standards containing the evidence-based recommendations most pertinent to primary care. The recommendations tables and figures included here retain the same numbering used in the full Standards and so are not numbered sequentially. All of the recommendations included here are substantively the same as in the full Standards. The abridged version does not include references. The complete 2021 Standards of Care, including all supporting references, is available at professional.diabetes.org/standards.1. Improving Care and Promoting Health in PopulationsDiabetes and Population HealthClinical practice recommendations can improve health across populations; however, for optimal outcomes, diabetes care must also be individualized for each patient. Thus, efforts to improve population health will require a combination of policy-level, system-level, and patient-level approaches. Patient-centered care is defined as care that 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 medical and psychosocial outcomes and must be addressed …

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