"This algorithm is a definitive, point-of-care tool for clinicians engaged in the treatment of those who are at risk for or have developed diabetes"
Friday, April 19, 2013 5:32 pm EDT
American Association of Clinical Endocrinologists (AACE) today
announced the publication of its new comprehensive diabetes management
algorithm created to guide primary care physicians, endocrinologists and
other health care professionals in the treatment of prediabetes and type
2 diabetes mellitus (T2DM) patients.
Recommendations in the algorithm, published online at
and in the March/April 2013 issue of the association’s peer-reviewed
Endocrine Practice, consider the whole
patient, the spectrum of risks and complications for the patient, and
evidence-based approaches to treatment.
Specifically, the document provides suggestions for treatment
prioritization and risk-reduction strategies while addressing the
following circumstances and conditions that frequently are precursors
to, or are concurrent with, a T2DM diagnosis:
Management of diabetes and co-existing diseases or disorders in the
prediabetic phase of disease.
A hierarchy of steps for the management of high blood sugar control
using an approach that balances age and comorbidities while minimizing
the adverse effects of hypoglycemia and weight gain.
Complications-centric treatment of the overweight or obese patient, as
opposed to a body mass index (BMI)-centric approach, including medical
and surgical treatments for greater weight loss.
Management of cardiovascular disease risk factors, hypertension and
hyperlipidemia (high lipid levels) in those patients with prediabetes
Among the algorithm’s key recommendations is that a comprehensive care
plan for persons with diabetes must now consider obesity management as
an integral part of the overall treatment plan to effectively reduce
morbidity, mortality and disability in the majority of patients with
T2DM who are obese.
Also, while suggesting an blood sugar goal of <6.5% as optimal for most
diabetes patients if it can be achieved in a safe manner, the algorithm
recommends the target be individualized based on numerous factors such
as age, comorbid conditions, duration of diabetes, risk of hypoglycemia,
patient motivation and adherence, and life expectancy. Higher targets
may be appropriate for some individuals and may change for a given
individual over time.
The algorithm includes every FDA-approved class of medications for
diabetes and differentiates the choice of therapies based on the
patient’s initial A1C.
“This algorithm is a definitive, point-of-care tool for clinicians
engaged in the treatment of those who are at risk for or have developed
diabetes,” said Alan
Garber, MD, PhD, FACE, chair of the algorithm task force and
President of AACE. “We have expanded on our previous efforts to address
broad-reaching, critical factors that accompany the disease and its
“With more than 100 million suffering from diabetes and prediabetes in
the United States, there simply are not enough endocrinologists to care
for all patients,” he added. “Thus, this algorithm is essential to
assist and educate clinicians who are charged with these patients’ care.”
About the American Association of Clinical
The American Association of Clinical Endocrinologists (AACE) represents
more than 6,500 endocrinologists in the United States and abroad. AACE
is the largest association of clinical endocrinologists in the world.
The majority of AACE members are certified in endocrinology, diabetes
and metabolism and concentrate on the treatment of patients with
endocrine and metabolic disorders including diabetes, thyroid disorders,
osteoporosis, growth hormone deficiency, cholesterol disorders,
hypertension and obesity. Visit our site at www.aace.com.