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Summary of Revisions for the 2004 Clinical Practice Recommendations

Additions to the Clinical Practice Recommendations

• "Diagnosis and Classification of Diabetes": A new position statement based on the "Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus," including the definition of pre-diabetes.
  

Deletions to the Clinical Practice Recommendations

• "Report of the Expert Committee on the Diagnosis and Classification of Diabetes"
  
• "Implications of the Diabetes Control and Complications Trial"
  
• "Implications of the United Kingdom Prospective Diabetes Study"
  

Summary of Revisions to current Position Statements

• "Standards of Medical Care in Diabetes"
  • Glycemic control: Updated recommendations, including recommendation that "more stringent goals (i.e., a normal A1C, <6%) can be considered in individual patients"
    
  • BP control: Updated recommendations based on recent studies (including ALLHAT)
    
  • Lipid management: Updated recommendations based on recent studies (including the Heart Protection Study) to include the recommendation that in people with diabetes over the age of 40 with a total cholesterol 135 mg/dl, statin therapy to achieve an LDL reduction of approximately 30% regardless of baseline LDL levels may be appropriate.
    
  • Anti-platelet agents: Clarified recommendation regarding aspirin use as primary prevention in type 1 and type 2 diabetes
    
  • Retinopathy: Updated recommendations including consideration of less frequent exams in low-risk patients on the advice of an eye care professional
    
  • Footcare: Updated recommendations on screening for peripheral arterial disease (PAD)
    
  • Care of older adults: Incorporated language from recent guidelines by the American Geriatric Society on this topic
    
  
  
• "Preventative Footcare in Diabetes": Updated recommendations on screening for peripheral arterial disease (PAD)
  
• "Hypertension Management in Adults with Diabetes": Updated recommendations based on recent studies (including ALLHAT)
  
• "Dyslipidemia Management in Adults with Diabetes": Updated recommendations based on recent studies (including the Heart Protection Study)
  
• "Smoking and Diabetes": Extensively revised
  
• Retinopathy in Diabetes: Updated recommendations, including consideration of less frequent exams in low-risk patients on the advice of an eye care professional
  
• "Test of Glycemia in Diabetes"
  
• "Diabetes Management in Correctional Institutions": Extensively revised.
  

Position Statement Title Changes

• Note that titles of some position statements have been shortened and revised to make them easier to identify electronically.
  

Members of the Professional Practice Committee
John B. Buse, MD, PhD, Chair

Jesse H. Ahroni, ARNP, PhD

George L. Bakris, MD, FACP

Evan M. Benjamin, MD

Jackie Boucher, MS, RD, LD, CDE

Fred L. Brancati, MD, MHS

Kenneth Copeland, MD

Marjorie L. Cypress, MS, RN, CDE

Vivian Fonseca, MD

Anne L. Peters Harmel, MD

David E. Kelley, MD

M. Sue Kirkman, MD

Lori M. Laffel, MD, MPH

Patrick J. O’Connor, MD, MPH

Michael P. Pignone, MD, MPH

Victor L. Roberts, MD, MBA, CDE

Madelyn L. Wheeler, MS, RD, CDE

Nathaniel G. Clark, MD, MS, RD (Staff)

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