James J. Chamberlain, MD; Rita Rastogi Kalyani, MD, MHS; Sandra Leal, PharmD, MPH; Andrew S. Rhinehart, MD; Jay H. Shubrook, DO; Neil Skolnik, MD; William H. Herman, MD, MPH
Acknowledgment: The full 2017 Standards of Medical Care in Diabetes was developed by the ADA's Professional Practice Committee: William H. Herman, MD, MPH, Co-Chair; Rita Rastogi Kalyani, MD, MHS, Co-Chair; Andrea L. Cherrington, MD, MPH; Donald R. Coustan, MD; Ian de Boer, MD, MS; R. James Dudl, MD; Hope Feldman, CRNP, FNP-BC; Hermes Florez, MD, PhD, MPH; Suneil K. Koliwad, MD, PhD; Melinda Maryniuk, MEd, RD, CDE; Joshua J. Neumiller, PharmD; and Joseph I. Wolfsdorf, MB, BCh.
Disclosures: Dr. Chamberlain reports personal fees from Merck, Sanofi-Aventis, Janssen, and Novo Nordisk during the conduct of the study. Dr. Rhinehart reports personal fees from Sanofi, Janssen, Boehringer Ingelheim, Novo Nordisk, Eli Lilly, Forest Pharmaceuticals, and AstraZeneca and employment with and stock in Glytec outside the submitted work. Dr. Shubrook reports being on advisory boards for Lilly Diabetes, Novo Nordisk, and Intarcia Therapeutics. Dr. Skolnik reports personal fees and nonfinancial support from AstraZeneca and Sanofi outside the submitted work; personal fees from Boehringer Ingelheim, Lilly, Teva, Janssen, and Intarcia outside the submitted work; and serving on the Primary Care Advisory Committee of the American Diabetes Association. Dr. Herman reports being on data monitoring committees for Lexicon Pharmaceuticals and Merck Sharp & Dohme 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=M17-1259.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy 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: St. Mark's Hospital & St. Mark's Diabetes Center, Internal Medicine at St. Mark's, 1160 East 3900 South, Suite 1200, Salt Lake City, UT 84124.
Dr. Kalyani: Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University, 1830 East Monument Street, Suite 333, Baltimore, MD 21287.
Dr. Leal: SinfoníaRx, 1 East Toole, Tucson, AZ 85701.
Dr. Rhinehart: Glytec, 231 Seahorse Court, Marco Island, FL 34145.
Dr. Shubrook: Touro University College of Osteopathic Medicine, 1310 Club Drive, Admin and Faculty 1, Room 117, Vallejo, CA 94592.
Dr. Skolnik: Abington Memorial Hospital, Abington Family Medicine, 500 Old York Road, Suite 108, Jenkintown, PA 19046.
Dr. Herman: University of Michigan, 1000 Wall Street, Room 6108/SPC 5714, Ann Arbor, MI 48105-1912.
Author Contributions: Conception and design: J.J. Chamberlain, R.R. Kalyani, S. Leal, A.S. Rhinehart, J.H. Shubrook, N. Skolnik.
Analysis and interpretation of the data: J.J. Chamberlain, S. Leal.
Drafting of the article: J.J. Chamberlain, R.R. Kalyani, S. Leal, A.S. Rhinehart, J.H. Shubrook, N. Skolnik.
Critical revision of the article for important intellectual content: J.J. Chamberlain, R.R. Kalyani, S. Leal, A.S. Rhinehart, N. Skolnik, W.H. Herman.
Final approval of the article: J.J. Chamberlain, R.R. Kalyani, S. Leal, A.S. Rhinehart, J.H. Shubrook, N. Skolnik, W.H. Herman.
Administrative, technical, or logistic support: J.J. Chamberlain, S. Leal.
Collection and assembly of data: J.J. Chamberlain, S. Leal, J.H. Shubrook.
The American Diabetes Association (ADA) annually updates 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 2017 Standards of Care, the ADA Professional Practice Committee did MEDLINE searches from 1 January 2016 to November 2016 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 of Care 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 recommendations from the 2017 Standards of Care about monitoring and pharmacologic approaches to glycemic management for type 1 diabetes.
Table 1. Pharmacokinetic Properties of Insulin Products*
Table 2. Classification of Hypoglycemia*
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James J. Chamberlain, Rita Rastogi Kalyani, Sandra Leal, Andrew S. Rhinehart, Jay H. Shubrook, Neil Skolnik, et al. Treatment of Type 1 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes. Ann Intern Med. 2017;167:493–498. doi: 10.7326/M17-1259
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Published: Ann Intern Med. 2017;167(7):493-498.
Published at www.annals.org on 12 September 2017
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Guidelines.
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