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    Home > Medical News > Medical World News > ADA's new 2015 diabetes care standard expands statin use

    ADA's new 2015 diabetes care standard expands statin use

    • Last Update: 2021-02-04
    • Source: Internet
    • Author: User
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    Most people with diabetes should receive at least moderate doses of statins regardless of their cardiovascular risk status, according to the American Diabetes Association's (ADA) annual update on diabetes management standards.
    2015 Diabetes Medical Care Standards also changed official recommendations when evaluating patients' use of statins based on a risk assessment of low-density lipoprotein (LDL) cholesterol levels in the blood. The change brings ADA's stance into step with 2013 advocated by the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines. ADA posted its revised standards online on December 23.
    Statin drug use recommendations are "an important change in how we provide care, a considerable change, but not a big change in what drugs most patients use," said Dr. Grant, a physician and researcher at Kaiser Medical Center in Oakland, Northern California, who is also the head of the 14-member panel of the ADA Professional Practice Committee that developed the revised standard.
    "We agree with the 2013 ACC and AHA lipid guidelines that the decision to start using statins should be based on the patient's cardiovascular risk, and as a result almost every patient with type 2 diabetes should take statins," Grant said in an interview.
    revised standard recommends "moderate" doses of statins for people aged 40-75 and older with diabetes over 75 who do not have other cardiovascular risk factors.
    this dose should be increased to a "high" dose for patients diagnosed with cardiovascular disease and those aged 40-75 with other cardiovascular risk factors. For patients over 75 years of age with cardiovascular risk factors, the new revised standard recommends the use of medium or high doses of statins.
    But for patients under the age of 40 who do not have cardiovascular disease or risk factors, the revised standard calls for the non-use of statins, for patients under 40 with risk factors, for medium or high doses of statins, and for diabetics with cardiovascular disease to use high doses of statins.
    ADA's recommendation not to use statins for the youngest and lowest risk diabetics is somewhat at issue with the 2013 ACC and AHA recommendations. For this patient population, the latter recommendation states that "statins should be individualized based on the benefits of reduced risk of cardiovascular disease from atherosclerosis, the likelihood of adverse events interacting with the drug, and the patient's preference for individual administration." "
    new standard revision includes several other changes, including:
    For diabetics, the recommended target diastic pressure is revised below 90mm Hg, an increase from the previous target of 80mm Hg. Prior to this, ADA's 2014 standard revised systolic pressure to less than 140mm Hg, which has also increased. Changing the lysopression target to less than 90mm Hg is primarily based on the best evidence available in the literature, Dr Grant said, because only low-level evidence supports targets below 80mm Hg. The revised standard also states that the new target of less than 140/90mm Hg makes it "co-ordinated" with the 2014 recommendations made by the Committee's panel at the Eighth Joint National Committee.
    , the recommended blood sugar target for pre-meal tests is 80-130mg/dL, a reduction from the previous limit of 70mg/dL. This change reflects new data on blood sugar levels associated with blood hemoglobin A levels.
    amendment reduces the body mass index (BMI) of Asian-Americans who are screened for overweight or obesity to 23 kg/m2 from 25 kg/m2 previously.
    a new chapter specifically designed for people with gestational diabetes that has previously been dispersed across the criteria, Grant explains. This section discusses the management of diabetes during pregnancy and of women with type 1 or type 2 diabetes long before pregnancy. (Lilac Garden)
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