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6. Glycemic Targets: Standards of Medical Care in Diabetes—2020

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American Diabetes Association·2020·Diabetes Care

Abstract

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc20-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc20-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

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  • A 2% decrease in HbA1c (eg, from 9% to 7%) lowers the probability of microvascular complications by 50% to 76%.

    “a 2% decrease in HbA1c (eg, from 9% to 7%) lowers the probability of microvascular complications by 50% to 76% [9].”

    From An Assessment of How Clinicians and Staff Members Use a Diabetes Artificial Intelligence Prediction Tool: Mixed Methods Study (2023) · cites this paper as [9]

    The A1C GOALS section reports that, in the DCCT trial of patients with type 1 diabetes, intensive control (mean A1C about 7%) versus standard control (about 9%) was associated with 50–76% lower rates of developing or progressing microvascular complications. The citing sentence omits that trial population and presents the result as a general effect of any 2% HbA1c decrease. (LLM, conf=0.84)

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2 of the 100 references couldn’t be matched to a known paper.

Research works printed but not linked: 8

  1. Lacy ME, Wellenius GA, Sumner AE, et al. Association of sickle cell trait with hemoglobin A 1c in African Americans. JAMA 2017;317:507- 515
  2. Lachin JM, Genuth S, Cleary P, Davis MD, Nathan DM; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy [published correction appears in N Engl J Med 2000;342:1376]. N Engl J Med 2000;342:381-389
  3. Lind M, Pivodic A, Svensson A-M, Ólafsdóttir AF, Wedel H, Ludvigsson J. HbA 1c level as a risk factor for retinopathy and nephropathy in children and adults with type 1 diabetes: Swedish pop- ulation based cohort study. BMJ 2019;366:l4894
  4. Sattar N, Rawshani A, Franzén S, et al. Age at diagnosis of type 2 diabetes mellitus and asso- ciations with cardiovascular and mortality risks. Circulation 2019;139:2228-2237
  5. Heinemann L, Freckmann G, Ehrmann D, et al. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycae- mia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial. Lancet 2018;391:1367-1377
  6. Beck RW, Riddlesworth T, Ruedy K, et al. Effect of Continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND random- ized clinical trial. JAMA 2017;317:371-378
  7. Lind M, Polonsky W, Hirsch IB, et al. Con- tinuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial. JAMA 2017;317:379-387
  8. Bolinder J, Antuna R, Geelhoed-Duijvestijn P, Kröger J, Weitgasser R. Novel glucose-sensing technology and hypoglycaemia in type 1 diabe- tes: a multicentre, non-masked, randomised controlled trial. Lancet 2016;388:2254-2263

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Authors
American Diabetes Association
Corresponding author
American Diabetes Association
Venue
Diabetes Care
Published
2019-12-16
Volume
43
Issue
Supplement_1
Pages
S66-S76
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
OpenAlex
W4235701932
Cited by
744
References
100
Citations by year
2026: 15 · 2025: 49 · 2024: 62 · 2023: 68 · 2022: 134 · 2021: 239 · 2020: 174 · 2019: 1
FWCI
111.14
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
glycemic targets, glycemic control, diabetes management, clinical guidelines, quality of care
MeSH terms
Glycemic Control, Blood Glucose, Diabetes Mellitus, Endocrinology, Humans, Patient Care Planning, Reference Standards, Societies, Medical, United States, History, 21st Century, Standard of Care

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