Updates to American Diabetes Association Guidelines

Every year, the American Diabetes Association releases clinical updates called Standards of Medical Care based on the results from the latest research studies to guide physicians to better manage Diabetes and its complications.

ADA has recently released an update in Standards of Medical Care in Diabetes -2021 in annotations as the Living Standards of Care. The revised guidelines include new research data on a new Diabetes drug and the effect of medication in people with chronic kidney disease. We summarise some of the important updates here:

•      A new drug called teplizumab is the first Diabetes medication for Type  1 Diabetes currently being studied for its efficacy in delaying the occurrence of Diabetes.  The guidelines  suggest that studying antibodies of people who have a familial history of Diabetes may help in the early detection of their risk of developing Type  1 Diabetes.

Teplizumab may help these people delay the occurrence of Type 1 Diabetes.

•      SGLT2 inhibitors are a class of drugs prescribed to people with Type 2 Diabetes to lower blood sugar levels. These drugs reduce high blood sugar levels by expelling the excess through urine. Various research studies have tried to observe the impact of newer drugs in this group of medications on the heart and kidney health of people with Diabetes. Empagliflozin has been found to have a significant positive impact on the kidney and heart health of people with or without Type 2 Diabetes. The drug was found to reduce the risk of serious complications, hospitalisation and organ failure. Also, sotagliflozin has been found to reduce the risk of death by a heart attack. Other drugs were found to have a moderate effect on severe complications of the heart and kidneys.

Dapagliflozin has been found to have a protective effect on the kidney health of people with or without Type 2 Diabetes

The drug has been found to prevent severe loss of kidney function, kidney failure and the risk of death by kidney or heart failure. Another drug called finerenone has been found to reduce the risk of developing heart failure and kidney dysfunction.

The guidelines highlight the possibility of achieving population health by implementing clinical recommendations for the masses. This includes personalised

care, a multidisciplinary care team and telemedicine for reaching people located in remote areas.