TAND**S OF MEDICAL CARE IN DIABETES—2010 内容预览 

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Standards of Medical Care in Diabetes—2010
Table of Contents
ADA Evidence Grading System for Clinical Recommendations
I. Classification and Diagnosis
Classification of Diabetes
Type 1 diabetes
β-cell destruction
Type 2 diabetes
Progressive insulin secretory defect
Other specific types of diabetes
Genetic defects in β-cell function, insulin action
Diseases of the exocrine pancreas
Drug- or chemical-induced
Gestational diabetes mellitus
Criteria for Diagnosis of Diabetes
Criteria for Diagnosis of Diabetes
Criteria for Diagnosis of Diabetes
Criteria for Diagnosis of Diabetes
Criteria for Diagnosis of Diabetes
Prediabetes: IFG, IGT, Increased A1C
II. TESTING FOR DIABETES IN ASYMPTOMATIC PATIENTS
Recommendations: Testing for Diabetes in Asymptomatic Patients
Consider testing overweight/obese **s with one or more additional risk factors
In those without risk factors, begin testing at age 45 years (B)
If tests are normal
Repeat testing at least at 3-year intervals (E)
Use A1C, FPG, or 2-h 75-g OGTT (B)
In those with increased risk for future diabetes
Identify and, if appropriate, treat other CVD risk factors (B)


III. DETECTION AND DIAGNOSIS OF GESTATIONAL DIABETES MELLITUS (GDM)
Recommendations: Detection and Diagnosis of GDM
Screen for GDM using risk factor **ysis and, if appropriate, an OGTT (C)
Women with GDM
Screen for diabetes 6-12 weeks postpartum
Follow up with subsequent screening for development of diabetes or pre-diabetes (E)
Screening for and Diagnosis of GDM (1)
Screening for and Diagnosis of GDM (2)
Screening for and Diagnosis of GDM (3)
Screening for and Diagnosis of GDM (4)
Screening for and Diagnosis of GDM (5)
Screening for and Diagnosis of GDM (6)
IV. PREVENTION/DELAY OF TYPE 2 DIABETES
Recommendations: Prevention/Delay of Type 2 Diabetes
Refer patients with IGT (A), IFG (E), or A1C 5.7-6.4% (E) to support program
Weight loss 5-10% of body weight
At least 150 min/week moderate activity
Follow-up counseling important (B); third-party payors should cover (E)
Consider metformin in those with combined IFG/IGT, other risk factors (E)
In those with prediabetes, monitor for development of diabetes annually (E)
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