Cited by 375Diabetes Treatment and ManagementDiabetes Management and ResearchDiabetes, Cardiovascular Risks, and Lipoproteins

American Association of Clinical Endocrinology consensus statement: comprehensive type 2 diabetes management algorithm—2023 update

Samson, Susan L., Vellanki, Priyathama, Blonde, Lawrence, Christofides, Elena A., Galindo, Rodolfo J., Hirsch, Irl B., Isaacs, Scott D., Izuora, Kenneth E. +4 more·2023·Endocrine Practice

Abstract

OBJECTIVE This consensus statement provides (1) visual guidance in concise graphic algorithms to assist with clinical decision-making of health care professionals in the management of persons with type 2 diabetes mellitus to improve patient care and (2) a summary of details to support the visual guidance found in each algorithm. METHODS The American Association of Clinical Endocrinology (AACE) selected a task force of medical experts who updated the 2020 AACE Comprehensive Type 2 Diabetes Management Algorithm based on the 2022 AACE Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan and consensus of task force authors. RESULTS This algorithm for management of persons with type 2 diabetes includes 11 distinct sections: (1) Principles for the Management of Type 2 Diabetes; (2) Complications-Centric Model for the Care of Persons with Overweight/Obesity; (3) Prediabetes Algorithm; (4) Atherosclerotic Cardiovascular Disease Risk Reduction Algorithm: Dyslipidemia; (5) Atherosclerotic Cardiovascular Disease Risk Reduction Algorithm: Hypertension; (6) Complications-Centric Algorithm for Glycemic Control; (7) Glucose-Centric Algorithm for Glycemic Control; (8) Algorithm for Adding/Intensifying Insulin; (9) Profiles of Antihyperglycemic Medications; (10) Profiles of Weight-Loss Medications (new); and (11) Vaccine Recommendations for Persons with Diabetes Mellitus (new), which summarizes recommendations from the Advisory Committee on Immunization Practices of the U.S. Centers for Disease Control and Prevention. CONCLUSIONS Aligning with the 2022 AACE diabetes guideline update, this 2023 diabetes algorithm update emphasizes lifestyle modification and treatment of overweight/obesity as key pillars in the management of prediabetes and diabetes mellitus and highlights the importance of appropriate management of atherosclerotic risk factors of dyslipidemia and hypertension. One notable new theme is an emphasis on a complication-centric approach, beyond glucose levels, to frame decisions regarding first-line pharmacologic choices for the treatment of persons with diabetes. The algorithm also includes access/cost of medications as factors related to health equity to consider in clinical decision-making.

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Crossref · 10.1016/j.eprac.2023.02.001

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177 of 177 references verified0 citation errors · 0 not checkable

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  • Recent guidelines call for continuous glucose monitoring (CGM) use for all who require insulin, regardless of diabetes type.

    “While recent guidelines call for continuous glucose monitoring (CGM) use for all who require insulin, regardless of diabetes type (7), there is also evidence that patients may not know how to interpret what to do with the CGM data (6, 8, 9).”

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4 of the 181 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. 2008, Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, et al. Effects of intensive glucose lowering in type 2 diabetes, N Engl J Med, 358, 2545
  2. Mechanick, 2019, Endocr Pract, 25, 1346

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Authors
Samson, S. L., Vellanki, P., Blonde, L., Christofides, E. A., Galindo, R. J., Hirsch, I. B., Isaacs, S. D., Izuora, K. E., Low Wang, C. C., Twining, C. L., Umpierrez, G. E., & Valencia, W. M.
Affiliations
  • Mayo Clinic (US)
  • Grady Memorial Hospital (US)
  • Ochsner Health System (US)
  • Indiana University Columbus (US)
  • University of Miami (US)
  • University of Washington (US)
  • Emory University (US)
  • University of Nevada, Las Vegas (US)
  • Maine Medical Center (US)
  • Cleveland Clinic (US)
Venue
Endocrine Practice
Publisher
Elsevier BV
Published
2023-05
Volume
29
Issue
5
Pages
305-340
ISSN
1530-891X (ISSN-L)
OpenAlex
W4372214811
Cited by
375
References
181
Citations by year
2026: 62 · 2025: 150 · 2024: 124 · 2023: 38 · 2022: 1
FWCI
76.07
Type
journal article
Language
en
Open access
closed
Locations
  • Endocrine Practice (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK123384)
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, Cardiovascular Risks, and Lipoproteins
Keywords
type 2 diabetes, prediabetes, glycemic control, dyslipidemia, hypertension, insulin intensification, antihyperglycemic medications, anti-obesity drugs, obesity, lifestyle modification, health equity
MeSH terms
Endocrinologists, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Endocrinology, Glucose, Humans, Hypertension, Obesity, Prediabetic State, United States, Dyslipidemias, Overweight

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