9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2023
Open accessAbstract
The American Diabetes Association (ADA) “Standards of 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, 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 and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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GLP-1 RAs are indicated for the treatment of type 2 diabetes (all) and obesity (liraglutide and semaglutide only) and have beneficial effects on patient-important outcomes such as weight loss, cardiovascular and kidney events, hepatic steatosis, and mortality.
“Clinically, GLP-1 RAs are indicated for the treatment of type 2 diabetes (all) and obesity (liraglutide and semaglutide only) and have beneficial effects on patient-important outcomes such as weight loss, cardiovascular and kidney events, hepatic steatosis, and mortality.5,7–9,11,30”
From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [8]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredModern treatment guidelines for type 2 diabetes and essential hypertension recommend a stepped care approach to pharmacotherapy.
“By contrast, modern treatment guidelines for type 2 diabetes 154 and essential hypertension 155 (also nutrition related chronic diseases), do recommend a stepped care approach to pharmacotherapy.”
From Effectiveness and safety of drugs for obesity (2024) · cites this paper as [154]
The Combination Therapy section (p. 10) describes stepwise addition of diabetes medications as a traditional recommendation and recommends intensifying treatment when goals are not met. It also says current intensification need not be purely sequential and may begin with combination therapy, so the claim overstates the guideline’s endorsement of stepped care. The hypertension portion is attached to a different citation and is not judged here. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGLP-1 RAs are contraindicated for patients with a personal or family history of MTC or those with multiple endocrine neoplasia syndrome type 2.
“As a result, GLP-1 RAs are contraindicated for patients with a personal or family history of MTC or those with multiple endocrine neoplasia syndrome type 2.8,17,22”
From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [8]
The clinical-considerations table (p. 9) mentions thyroid C-cell tumors in rodents but says their relevance to humans is undetermined. Our copy does not state that GLP-1 RAs are contraindicated for patients with a personal or family history of MTC or with multiple endocrine neoplasia syndrome type 2 (searched: MTC, MEN2, and thyroid-cancer contraindications). (LLM, conf=0.73)
Experimental — accuracy not yet measuredA 5% weight reduction is insufficient to improve many aspects of health, and greater weight losses confer greater benefits, with some data suggesting a threshold effect for reduction in some important comorbidities such as cardiovascular disease and diabetes remission.
“However, a 5% weight reduction is insufficient to improve many aspects of health, and greater weight losses confer greater benefits, 23,82,83 with some data suggesting that there may be a threshold effect for reduction in some important comorbidities such as CVD and diabetes remission.[84][85][86]”
From Approach to Obesity Treatment in Primary Care: A Review (2024) · cites this paper as [84]
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Use of SGLT2 Inhibitors vs GLP-1 RAs and Anemia in Patients With Diabetes and CKD
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Novel Anti-obesity Therapies and their Different Effects and Safety Profiles: A Critical Overview
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- Authors
- ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R. A.
- ORCID
- ElSayed, Nuha A.
- Aleppo, Grazia
- Aroda, Vanita R.
- Bannuru, Raveendhara R.
- Brown, Florence M.
- Bruemmer, Dennis
- Collins, Billy S.
- Hilliard, Marisa E.
- Isaacs, Diana
- Johnson, Eric L.
- Kahan, Scott
- Khunti, Kamlesh
- Lyons, Sarah K.
- Perry, Mary Lou
- Prahalad, Priya
- Pratley, Richard E.
- Seley, Jane Jeffrie
- Stanton, Robert C.
- Gabbay, Robert A.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2022-12-12
- Volume
- 46
- Issue
- Supplement_1
- Pages
- S140-S157
- ISSN
- 0149-5992 (ISSN-L)
- PMC
- PMC9810476
- OpenAlex
- W4311264067
- Semantic Scholar
- f75bf88f7fa4c4c0cf940dad739ba96bb6d15d64
- Cited by
- 851
- References
- 114
- Citations by year
- 2026: 64 · 2025: 149 · 2024: 360 · 2023: 277 · 2022: 1
- FWCI
- 28.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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
- glycemic control, pharmacotherapy, diabetes mellitus, antidiabetic drugs, clinical guidelines, treatment goals, quality of care
- MeSH terms
- Diabetes Mellitus, Endocrinology, Humans, Reference Standards, Societies, Medical, Standard of Care
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