Diabetes Pro Quarterly - Spring 2018 - 1

SPRING 2018

DiabetesPro
QUARTERLY
A M E R I C A N D I A B E T ES A S S O C I AT I O N
N E W S FO R P R O F ES S I O N A L M E M B E R S

The American Diabetes Association, the American
Association of Clinical Endocrinologists, the American
Association of Diabetes Educators, and the Endocrine
Society Strongly Disagree with the American College of
Physicians' Guidance for Higher Blood Glucose Targets
for People with Type 2 Diabetes

IN THIS ISSUE
Call to Congress

2

Announcing the Membership
Advisory Group

4

Focus on Fellows Celebrates
5th Anniversary

8

Scientific Sessions Major
Lectures and Addresses

13

The American Diabetes Association (ADA), the American Association of Clinical
Endocrinologists (AACE), the American Association of Diabetes Educators (AADE),
and the Endocrine Society are unified in their strong opposition to the American
College of Physicians' (ACP's) proposed new guidance that suggests higher blood
glucose targets for people with type 2 diabetes. Although there is agreement on
individualization of treatment based on patient-specific factors with the aim of
protecting those at highest risk, the ACP's recommendation of blood glucose targets
for A1C "from 7 to 8 percent" could prevent many patients from receiving the full
benefits of long-term glycemic control. ADA, AACE, AADE, and the Endocrine
Society are also concerned that the broad range suggested by ACP's guidance is too
large to apply to "most patients with type 2 diabetes" and has the potential to do more
harm than good for many patients for whom lower blood glucose targets may be more
appropriate, particularly given the increased risk of serious complications such as
cardiovascular disease, retinopathy, amputation, and kidney disease that results
from higher blood glucose (A1C) levels.
Although ACP's guidance is only one additional percentage point above the other
organizations' recommendations, this may equate to a difference of nearly 30 points
when blood glucose is measured in milligrams per deciliter. This difference in the
lower and higher ends of the A1C range ACP suggests also has been shown in large,
multicenter randomized trials of patients newly diagnosed with type 2 diabetes to
result in clear differences in the development of microvascular complications.
The ACP's new guidance, "Hemoglobin A1C Targets for Glycemic Control with
Pharmacologic Therapy for Nonpregnant Adults with Type 2 Diabetes Mellitus:
A Guidance Statement Update from the American College of Physicians," was
published in the Annals of Internal Medicine on March 5, 2018. It was developed
based on analysis of the same international clinical trials for people with type 2
diabetes reviewed by each of the other organizations, including the Professional
Practice Committee for the ADA's Standards of Medical Care in Diabetes-2018 and
the recommendations of AACE and AADE. These trials included ACCORD (Action
to Control Cardiovascular Risk in Diabetes), ADVANCE (Action in Diabetes and
Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation),
VADT (Veterans Affairs Diabetes Trial), and UKPDS (U.K. Prospective Diabetes Study).
continued on page 2

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Table of Contents for the Digital Edition of Diabetes Pro Quarterly - Spring 2018
