James J. Chamberlain, MD; Eric L. Johnson, MD; Sandra Leal, PharmD, MPH, CDE; Andrew S. Rhinehart, MD, CDE; Jay H. Shubrook, DO; Lacie Peterson, MS, RD, CDE
Acknowledgment: The authors thank Sarah Bradley; Matt Petersen; and Erika Gebel Berg, PhD, for their invaluable assistance in the reviewing and editing of this manuscript. The full Standards of Medical Care in Diabetes—2018 was developed by the ADA's Professional Practice Committee: Rita R. Kalyani, MD, MHS (Chair); Christopher Cannon, MD; Andrea L. Cherrington, MD, MPH; Donald R. Coustan, MD; Ian de Boer, MD, MS; Hope Feldman, CRNP, FNP-BC; Judith Fradkin, MD; David Maahs, MD, PhD; Melinda Maryniuk, Med, RD, CDE; Medha N. Munshi, MD; Joshua J. Neumiller, PharmD, CDE; and Guillermo E. Umpierrez. ADA staff support includes Erika Gebel Berg, PhD; Tamara Darsow, PhD; Matt Petersen; Sacha Uelmen, RDN, CDE; and William T. Cefalu, MD.
Disclosures: Dr. Chamberlain reports other support from Novo Nordisk, Sanofi Aventis, Janssen, and Merck outside the submitted work. Dr. Johnson reports personal fees from Novo Nordisk, Medtronic, and Sanofi outside the submitted work. Dr. Rhinehart reports employment with and stock ownership in Glytec. Dr. Shubrook reports personal fees from Novo Nordisk, Lilly Diabetes, and Intarcia outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0222.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Requests for Single Reprints: James J. Chamberlain, MD, St. Mark's Hospital and St. Mark's Diabetes Center, Internal Medicine at St. Mark's, 1160 East 3900 South, Suite 1200, Salt Lake City, UT 84124; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. Chamberlain: Medical Director for Diabetes Services, St. Mark's Hospital and St. Mark's Diabetes Center, Internal Medicine at St. Mark's, 1160 East 3900 South, Suite 1200, Salt Lake City, UT 84124.
Dr. Johnson: Assistant Medical Director, Altru Diabetes Center, Associate Professor, Family and Community Medicine, UND School of Medicine and Health Sciences, 1301 North Columbia Road, Grand Forks, ND 58201.
Dr. Leal: Vice President for Innovation, SinfoníaRx, 1 East Toole, Tucson, AZ 85701.
Dr. Rhinehart: Chief Medical Officer, Glytec, LLC, 231 Seahorse Court, Marco Island, FL 34145.
Dr. Shubrook: Professor, Director of Diabetes Services, Touro University College of Osteopathic Medicine, 1310 Club Drive, Admin and Faculty 1, Room 117, Vallejo, CA 94592.
Ms. Peterson: Clinical Assistant Professor, Utah State University, 920 West Levoy Drive, Taylorsville, UT 84123.
Author Contributions: Conception and design: J.J. Chamberlain, S. Leal, A.S. Rhinehart, J.H. Shubrook.
Analysis and interpretation of the data: J.J. Chamberlain, S. Leal, A.S. Rhinehart.
Drafting of the article: J.J. Chamberlain, E.L. Johnson, S. Leal, A.S. Rhinehart, J.H. Shubrook, L. Peterson.
Critical revision of the article for important intellectual content: J.J. Chamberlain, E.L. Johnson, S. Leal, A.S. Rhinehart.
Final approval of the article: J.J. Chamberlain, E.L. Johnson, S. Leal, A.S. Rhinehart, J.H. Shubrook, L. Peterson.
Administrative, technical, or logistic support: J.J. Chamberlain.
Collection and assembly of data: J.J. Chamberlain, E.L. Johnson, S. Leal, J.H. Shubrook, L. Peterson.
The American Diabetes Association (ADA) annually updates its Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes.
For the 2018 standards, the ADA Professional Practice Committee searched MEDLINE through November 2017 to add, clarify, or revise recommendations on the basis of new evidence. The committee rated the recommendations as A, B, or C depending on the quality of evidence or E for expert consensus or clinical experience. The standards were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community informed revisions.
This synopsis focuses on guidance relating to cardiovascular disease and risk management in nonpregnant adults with diabetes. Recommendations address diagnosis and treatment of cardiovascular risk factors (hypertension and dyslipidemia), aspirin use, screening for and treatment of coronary heart disease, and lifestyle interventions.
Chamberlain JJ, Johnson EL, Leal S, Rhinehart AS, Shubrook JH, Peterson L. Cardiovascular Disease and Risk Management: Review of the American Diabetes Association Standards of Medical Care in Diabetes 2018. Ann Intern Med. ;168:640–650. doi: 10.7326/M18-0222
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Published: Ann Intern Med. 2018;168(9):640-650.
Published at www.annals.org on 3 April 2018
Cardiology, Coronary Risk Factors, Diabetes, Dyslipidemia, Endocrine and Metabolism.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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