The DOI matches its Crossref record; 1,861 of the 1,959 references it cites were found in a registry or an index; 7 of the 11 sources its claims cite were checked for support.
American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.
Open accessAbstract
Objective The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. Methods The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. Results This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. Conclusions This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Claims the paper makes
20 Own method · 2 Partly supported · 1 Couldn’t confirm · 1 No basis given · accuracy not yet measured
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“A glucose level ≥200 mg/dL in the presence of hyperglycemia symptoms such as polyuria and polydipsia confirm the diagnosis of DM.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Evidence Base 1: How is the diagnosis of DM made and what is the current screening protocol for prediabetes and DM?
What the sources say
- Could not verifycites [6] sourceExperimental — accuracy not yet measured
The Diagnostic testing passage (page unavailable) discusses fasting glucose, HbA1c, C-peptide, and antibody tests for evaluating MODY. Neither it nor the other retrieved passages gives a ≥200 mg/dL glucose threshold with hyperglycemia symptoms for diagnosing diabetes; searches for that threshold and symptom-based criterion found no supporting passage in our copy. (LLM, conf=0.73)
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The concordance between FPG, 2-hour PG, and A1C is not perfect; thus, the diagnosis of DM requires 2 different (fasting glucose and A1C) abnormal test results, either from the same sample or 2 abnormal results on samples drawn on different days.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Evidence Base 1: How is the diagnosis of DM made and what is the current screening protocol for prediabetes and DM?
What the sources say
- Partly supportedcites [3] sourceExperimental — accuracy not yet measured
The paper’s introductory passage says diabetes diagnosis requires confirmation of an elevated glucose or HbA1c result and that two different tests above diagnostic thresholds can provide confirmation. It also says repeating the same test on a later sample is preferred, so two different tests are not required. The Discussion says guidelines were unclear about using two tests from one sample; our copy does not address the quoted exception for symptoms with glucose of at least 200 mg/dL or concordance involving 2-hour PG. (LLM, conf=0.87)
- Partly supportedcites [4] sourceExperimental — accuracy not yet measured
The paper’s opening section says that FPG or 2-hour glucose meets the usual diagnostic criteria when abnormal on more than one occasion, and that classic symptoms with a single random plasma glucose of at least 200 mg/dL are diagnostic. It does not say that confirmation requires two different tests (FPG and A1C), or that two abnormal results from the same sample suffice. Its discussion of test variability supports imperfect reproducibility, but not that specific confirmation rule. (LLM, conf=0.88)
- Partly supportedcites [5] sourceExperimental — accuracy not yet measured
The Discussion reports imperfect agreement among HbA1c, fasting plasma glucose, and 2-hour plasma glucose, and says diabetes diagnosis requires repeated measurement rather than a single test. It does not specify that the two abnormal results must be from different tests, describe the same-sample or different-day options, or state an exception for hyperglycemic symptoms with glucose of at least 200 mg/dL. (LLM, conf=0.88)
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Universal screening is recommended, as selective screening (only in women with risk factors) would miss a significant number of women with GDM and universal screening has been shown to be cost-effective compared with selective screening.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Evidence Base 1: How is the diagnosis of DM made and what is the current screening protocol for prediabetes and DM?
What the sources say
- Not matchedcites [9]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Partly supportedcites [50] sourceExperimental — accuracy not yet measured
The Conclusions recommend GDM screening at 24–28 weeks using a 75-g OGTT. The paper does not compare universal screening with risk-factor-based selective screening or report that universal screening is cost-effective; searches for selective screening and cost-effectiveness found no such comparison. (LLM, conf=0.84)
- Not checked — no full text of the sourcecites [51] source
- Not checked — no full text of the sourcecites [52] source
- Not checked — no full text of the sourcecites [53] source
- Partly supportedcites [54] sourceExperimental — accuracy not yet measured
Section 5.2 recommends universal testing because risk-factor-based selective testing has poor sensitivity for detecting GDM. But section 5.4 says there is a lack of good evidence for the cost-effectiveness of universal testing in both high- and low-resource countries; it does not establish that universal screening is cost-effective compared with selective screening. (LLM, conf=0.90)
- Could not verifycites [55] sourceExperimental — accuracy not yet measured
The Conclusions discuss childhood glucose outcomes after maternal GDM, not whether universal screening is recommended. Searches of our copy for selective screening, missed cases, and cost-effectiveness found no passage addressing those claims. (LLM, conf=0.76)
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Real-time CGM (rtCGM) or isCGM is recommended for all persons with T1D, regardless of insulin delivery system, to improve A1C levels and to reduce the risk for hypoglycemia and DKA.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Question 3: When and how should glucose monitoring be used?
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“DM is diagnosed by using any of 3 established criteria for elevated blood glucose (BG) concentrations (Table 4). FPG ≥126 mg/dL, 2-hour PG ≥ 200 mg/dL during 75-g OGTT, and A1C ≥ 6.5% are equally appropriate for diagnostic screening (Table 4).”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Evidence Base 1: How is the diagnosis of DM made and what is the current screening protocol for prediabetes and DM?
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For most hospitalized persons with hyperglycemia in both the intensive care unit (ICU) and non-ICU settings, a glucose range of 140 to 180 mg/dL is recommended, provided this target can be safely achieved (Table 6).”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Question 2. What are the glycemic treatment goals for persons with DM?
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetic peripheral neuropathy (DPN) is a clinical diagnosis. A comprehensive differential diagnosis should be considered to rule out nondiabetic neuropathies.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 2: Comorbidities and Complications > Question 8: How should neuropathy be diagnosed and managed in persons with DM?
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All persons who use insulin should use CGM or perform BG monitoring (BGM) a minimum of twice daily and ideally before any insulin injection.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Question 3: When and how should glucose monitoring be used?
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A1C should be measured at least semiannually in all persons with DM and at least quarterly in persons not at their glycemic target.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Question 3: When and how should glucose monitoring be used?
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Screening for DPN should be done at diagnosis of T2D, within 5 years of the diagnosis of T1D, and subsequently annually or whenever symptoms occur, by performing a clinical history and physical exam.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 2: Comorbidities and Complications > Question 8: How should neuropathy be diagnosed and managed in persons with DM?
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Continuous access to CGM for daily use is suggested for people living with T2DM at higher risk of hypoglycaemia, similar to the current CGM clinical practice guideline recommendations from Diabetes Canada 56 and the American Association of Clinical Endocrinologists. 57”
From Continuous glucose monitoring in noninsulin‐treated type 2 diabetes: A critical review of reported trials with an updated systematic review and meta‐analysis of randomised controlled trials (2025) · cites this paper as [57]
Experimental — accuracy not yet measuredIn the citing paper
“Approximately 2–5 times more patients discontinued orforglipron versus placebo due to adverse events, comparable to other GLP‐1 receptor agonists where 5%–15% discontinue in clinical trials [48].”
From Efficacy and Safety of Orforglipron in Obese Adults With or Without Diabetes: A Systematic Review and Meta‐Analysis (2025) · cites this paper as [48]
In the citing paper
“Current guideline recommendations by the American Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), American College of Sports Medicine (ACSM), American Association of Clinical Endocrinology (AACE), and the American Heart Association (AHA) advocate regular resistance and aerobic exercise, as well as physical activity such as increasing daily steps to avoid sed”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [23]
In the citing paper
“AACE and the ADA recommend avoiding no more than 2 to 3 days between exercise routines to maintain improvement in insulin sensitivity.”
From The Impact of Physical Activity in Patients With Type 2 Diabetes (2025) · cites this paper as [23]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 2: Comorbidities and Complications > Question 6: How should DKD or CKD in DM be managed?
“An SGLT2i with proven benefit is recommended as foundational therapy for persons with T2D and CKD with eGFR ≥20 mL/min/1.73 m2 to reduce progression of CKD and risk of CVD.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 2: Comorbidities and Complications > Evidence Base 6: How should DKD or CKD in DM be managed?
“An SGLT2i with proven kidney protection is recommended for people with T2D who have an eGFR >25 mL/min/1.73 m2 irrespective of albuminuria to reduce risks of DKD or CKD in DM and CVD.425,443–469 In those with HF, one agent in the class, empagliflozin, can be used with an eGFR as low as 20 mL/min/1.73 m2.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Section 1: Screening, Diagnosis, Glycemic Targets, and Glycemic Monitoring
“The one-step approach uses a 2-hour 75-g oral glucose tolerance test (OGTT) after ≥8 hours of fasting with diagnostic cutoffs of one or more FPG ≥92 mg/dL, 1-hour PG ≥180 mg/dL, or 2-hour PG ≥153 mg/dL.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 3: Management of Prediabetes, T2D, and T1D With Selection of Glycemic Targets, Lifestyle Interventions, and Antihyperglycemic Pharmacotherapy (Insulin Therapy for all With T1D and Select Individuals With T2D); Prevention, Identification, and Treatment of Hypoglycemia; Treatment of Hospitalized Persons With DM or Those With Hyperglycemia Without Diagnosis of DM; and Women With GDM > Evidence Base 16: How should DM in pregnancy be managed?
“Glucose criteria diagnostic for GDM are an FPG >92 mg/dL, 1-hour postglucose challenge value ≥180 mg/dL, or 2-hour value ≥153 mg/dL.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 2: Comorbidities and Complications > Evidence Base 10: How should obesity be managed in persons with DM?
“A phase 2 study in persons with biopsy-proven NASH using a daily injection equivalent to semaglutide 2.4 g/week demonstrated 13% weight loss”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Section 2: Comorbidities and Complications > Evidence Base 10: How should obesity be managed in persons with DM?
“Subcutaneous semaglutide at the higher dose of 2.4 mg/week has been approved for chronic weight management”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Section 1: Screening, Diagnosis, Glycemic Targets, and Glycemic Monitoring
“Diagnosis of DM requires 2 abnormal test results, either from the same sample or 2 abnormal results on samples drawn on different days.”
§ American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Pland—2022 Update > Recommendations and Evidence Bases > Evidence Base 1: How is the diagnosis of DM made and what is the current screening protocol for prediabetes and DM?
“the diagnosis of DM requires 2 different (fasting glucose and A1C) abnormal test results, either from the same sample or 2 abnormal results on samples drawn on different days.”
Cited works that were retracted
Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“Adler, 2021, Reprint of: Classification of diabetes mellitus, Diabetes Res Clin Pract, 10.1016/j.diabres.2021.108972”
Cited work 10.1016/j.diabres.2021.108972 · retracted 2021-07-31 · notice 10.1016/j.diabres.2021.108972 · this paper published 2022-10
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Self-citation
Metadata
- Authors
- Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., Gardner, T. W., Garg, R., Garvey, W. T., Hirsch, I. B., Hurley, D. L., Izuora, K., Kosiborod, M., Olson, D., Patel, S. B., Pop-Busui, R., Sadhu, A. R., Samson, S. L., Stec, C., Tamborlane, W. V., Tuttle, K. R., Twining, C., Vella, A., Vellanki, P., & Weber, S. L.
- Affiliations
- Ochsner Health System (US)
- Emory University (US)
- Central Michigan University (US)
- Washington University in St. Louis (US)
- University at Buffalo, State University of New York (US)
- Cedars-Sinai Medical Center (US)
- The University of Texas at San Antonio (US)
- Scripps Whittier Diabetes Institute (US)
- University of Michigan (US)
- University of California, Los Angeles (US)
- University of Alabama at Birmingham (US)
- University of Washington (US)
- Mayo Clinic (US)
- University of Nevada, Las Vegas (US)
- Saint Luke's Hospital (US)
- Colorado Health Foundation (US)
- University of Cincinnati Medical Center (US)
- Houston Methodist (US)
- Mayo Clinic in Florida (US)
- American Association of Clinical Endocrinologists (US)
- Yale University (US)
- Maine Medical Center (US)
- Prisma Health (US)
- ORCID
- Blonde, Lawrence
- Umpierrez, Guillermo E.
- McGill, Janet B.
- Berga, Sarah L.
- Bush, Michael
- Chandrasekaran, Suchitra
- DeFronzo, Ralph A.
- Einhorn, Daniel
- Galindo, Rodolfo J.
- Gardner, Thomas W.
- Garg, Rajesh
- Garvey, W. Timothy
- Hirsch, Irl B.
- Hurley, Daniel L.
- Izuora, Kenneth
- Kosiborod, Mikhail
- Patel, Shailendra B.
- Sadhu, Archana R.
- Samson, Susan L.
- Tamborlane, William V.
- Tuttle, Katherine R.
- Vella, Adrian
- Vellanki, Priyathama
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2022-10
- Volume
- 28
- Issue
- 10
- Pages
- 923-1049
- ISSN
- 1530-891X (ISSN-L)
- PMC
- PMC10200071
- OpenAlex
- W4291397630
- Cited by
- 507
- References
- 1,959
- Citations by year
- 2026: 95 · 2025: 119 · 2024: 150 · 2023: 134 · 2022: 9
- FWCI
- 76.49
- Type
- journal article
- Language
- en
- Update notices
- erratum (2023-01-01)
- Open access
- bronze
- doi.org
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (K23DK123384, P30DK111024)
- National Institute of Diabetes and Digestive and Kidney Diseases
- BP
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- diabetes mellitus, comprehensive diabetes care, glycemic targets, blood glucose monitoring, diabetes complications, obesity, bariatric surgery, hypertension, dyslipidemia, diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, cardiovascular disease, prediabetes, type 2 diabetes, type 1 diabetes, insulin therapy, hypoglycemia, diabetes in pregnancy, diabetes education, infertility, dietary supplements, social determinants of health, virtual care, cancer risk, pediatric diabetes care, depression, sleep medicine, team-based care
- MeSH terms
- Child, Diabetes Mellitus, Type 2, Endocrinology, Female, Humans, Hypoglycemic Agents, Insulin, Pregnancy, United States, Dyslipidemias
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