Summary of Revisions for the 2003 Clinical Practice Recommendations

Additions to the Clinical Practice Recommendations

1. “Diabetic Retinopathy” was rewritten and incorporates ADA’s evidence-based grading system

Summary of Revisions to Position Statements

The following position statements had substantial revisions that are outlined below:

“Standards of Medical Care for Patients With Diabetes Mellitus”

1. Added a table on the relationship between A1C levels and mean plasma glucose levels

2. Included a summary table with goals for glycemia, lipids, and blood pressure

3. Clarified that the assessment for microalbuminuria should begin with analbumin-to-creatinine ratio from a spot urine sample

4. Updated recommendations for the treatment of hypertension and nephropathy

“Treatment of Hypertension in Adults With Diabetes”

1. Updated recommendations for the treatment of hypertension

“Diabetic Nephropathy”

1. Updated recommendations for the treatment of nephropathy

“Third Party Reimbursement for Diabetes Care, Self-Management Education, and Supplies”

1. Added language addressing the potential impact of formulary restriction and prior authorizations for medications, equipment, and supplies

“Translation of the Diabetes Nutrition Recommendations for Health Care Institutions”

1. Updated the primary goals of medical nutrition therapy (MNT) for diabetes

2. Revised language around the use of regular diets for nursing home residents based on a recent study

“Test of Glycemia in Diabetes”

1. Added a table on the relationship between A1C levels and mean plasma glucose levels

“Insulin Administration”

1. Included information on temporary insulin brand substitution

2. Added information on the use of insulin syringes with engineered sharps injury protection