New recommendations for 2024

In the last hours the new recommendations or the care standards that the American Diabetes Association, the ADA have been announced, and that mark the guide to follow by health professionals in the care of people with diabetes.Cardiovascular risk, or early detection of diabetes are the most significant changes.

"The rules of care are essentially the global guidelines for the care of people with diabetes and people at risk," said the scientific and medical director of the ADA, Robert Gabbay, MD, PHD, during an informative session in which he announcedThe new standards.

The document was developed through a review of the scientific literature by the Ada Professional Practice Committee.The panel is made up of 21 professionals, including doctors from many specialties, practical nurses, specialists certified in the care and education of diabetes, dietitians and pharmacists.It can be reviewed since December 11, 2023, as a supplement in Care diabetes.The novelties for this year are the following.

Heart failure detection

We have known for a long time that people with type 2 diabetes have a high risk of cardiovascular problems.The ADA recommends paying special attention to the detection of adults with diabetes to detect asymptomatic heart failure by measurement of natural peptides levels to facilitate prevention or progression to the symptomatic stages of heart failure.

According to Dr. Gabbay, “these recommendations are really to detect more aggressive people with high risk of heart failure with a simple blood test and, based on those values, to be able to move on to greater evaluation and echocardiography, byexample.

Diabetes detection type 1

From the prevention of diabetes we will hear a lot in the coming years.The detection of type 1 diabetes before debut can allow health professionals to intervene and delay complications.

The detection of first -degree relatives of people with type 1 diabetes is a high priority because they run a high risk of also developing diabetes.

This new reality has also been taken into account by the ADA, and that is why they recommend investigating the suspicion of type 1 diabetes in newly diagnosed adults using islet autoantibodies tests and diagnostic criteria for preclinical stages based on the recent approval of Teplizumab fordelay the appearance of type 1 diabetes.

peripheral arterial disease detection

Experts say that amputation rates in people with diabetes are increasing, unlike many other complications.For example, it is known that black people have two to four times more likely than whites to have an amputation.

Many patients do not show common symptoms of peripheral arterial disease.Early detection is the most important way to find out whether or not they have it, because it can be a very devastating disease.

For this reason, the new recommendation is to detect peripheral arterial disease with ankle-brachial index tests in asymptomatic people with diabetes that are ≥ 50 years old and have microvascular disease anywhere, complications in the foot or any damage to the terminal organ bydiabetes.The document also advises the consideration of the detection of the EAP for all the people who have had diabetes for ≥ 10 years.

obesity management

The new recommendations here include the use of anthropomorphic measurements beyond the mass indexbody to include the circumference of the waist and the proportion of waist: hip and the individual evaluation of the mass and distribution of body fat.

The individualization of obesity management is encouraged, including behavioral, pharmacological and surgical approaches.

other new recommendations

Among the many other reviews in the 2024 document are new recommendations on the regular evaluation and treatment of bone health, the evaluation of disability and the orientation for the derivation, and the alignment of the orientation for detection and managementof liver disease with those of other professional societies.

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