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American Association of Clinical Endocrinology consensus statement: comprehensive type 2 diabetes management algorithm—2023 update
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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“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).”
From Observed Glycemic and Psychosocial Benefits in the Prospective Bigfoot Unity Real World Study: A 6-Month Analysis (2025) · cites this paper as [7]
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BackgroundNadolsky, K., Garvey, W. T., Agarwal, M., Bonnecaze, A., Burguera, B., Chaplin, M. D., Griebeler, M. L., Harris, S. R., Schellinger, J. N., Simonetti, J., et al. (2025) · Endocrine Practice · doi:10.1016/j.eprac.2025.07.017 · Cited by 141
Metformin: Therapeutic profile in the treatment of type 2 diabetes
Bailey, C. J. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15663 · Cited by 143
Singh, B., Ahmed, M., Staiano, A. E., Gough, C., Petersen, J., Vandelanotte, C., Kracht, C., Huong, C., Yin, Z., Vasiloglou, M. F., et al. (2024) · npj Digital Medicine · doi:10.1038/s41746-024-01172-y · Cited by 115
“…daily energy intake is associated with https://doi.org/10.1038/s41746-024-01172-y improvedweightstatus,adiposity,andmetabolicsyndromeriskreduction 30 , it is worth noting that the average reduction of 103 kcals/day, as highlighted in this review, may not meet the >5% to ≥ 10% recommended energy…”
Influential
Metadata
- 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)
- ORCID
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2023-05
- Volume
- 29
- Issue
- 5
- Pages
- 305-340
- ISSN
- 1530-891X (ISSN-L)
- OpenAlex
- W4372214811
- Semantic Scholar
- 066a5bccabf1b093084ed77c43509daa1c94c321
- Cited by
- 375
- References
- 181
- Citations by year
- 2026: 62 · 2025: 150 · 2024: 124 · 2023: 38
- FWCI
- 76.07
- Type
- journal article
- Language
- en
- Update notices
- 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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