The document summarizes revisions made to the 2010 Clinical Practice Recommendations. Several sections were extensively revised, including the diagnosis of diabetes, pre-diabetes categories, diabetes self-management education, and antiplatelet therapy guidelines. New recommendations address cystic fibrosis-related diabetes, retinopathy screening, inpatient diabetes care, and strategies for improving overall diabetes care.

1. S U M M A R Y O F R E V I S I O N S
Summary of Revisions for the 2010
Clinical Practice Recommendations
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eginning with the 2005 supple- Revisions to the “Standards of The section “Diabetes self-management
ment, the Clinical Practice Recom- Medical Care in Diabetes” education” has been extensively revised
mendations contained only the In addition to many small changes related to reflect new evidence.
“Standards of Medical Care in Diabetes” to new evidence since the previous ver- ● The section “Antiplatelet agents” has
and selected other position statements. sion, the following sections have under- been extensively revised to reflect re-
This change was made to emphasize the gone major changes: cent trials questioning the benefit of as-
importance of the “Standards” as the best pirin for primary cardiovascular disease
source to determine American Diabetes ● The section “Diagnosis of diabetes” has prevention in moderate- or low-risk
Association recommendations. The posi- been revised to include the use of A1C patients. The recommendation has
tion statements in the supplement are up- to diagnose diabetes, with a cut point of changed to consider aspirin therapy as
dated yearly. Position statements not 6.5%. a primary prevention strategy in those
included in the supplement will be up- ● The section previously titled “Diagnosis with diabetes at increased cardiovascu-
dated as necessary and republished when of pre-diabetes” has been renamed
lar risk (10-year risk 10%). This in-
updated. A list of the position statements “Categories of increased risk for diabe-
cludes men 50 years of age or women
not included in this supplement appears tes.” In addition to impaired fasting glu-
on p. S100. cose and impaired glucose tolerance, an 60 years of age with at least one ad-
A1C range of 5.7– 6.4% has been in- ditional major risk factor.
● The section “Retinopathy screening
cluded as a category of increased risk
Additions to the “Standards of for future diabetes. and treatment” has been updated to
Medical Care in Diabetes” ● The section “Detection and diagnosis of include a recommendation on use of
GDM” has been revised to discuss po- fundus photography as a screening
● A section on cystic fibrosis–related dia- tential future changes in the diagnosis strategy.
betes has been added. based on international consensus. ● The section “Diabetes care in the hospi-
tal” has been extensively revised to re-
flect new evidence calling into question
very tight glycemic control goals in crit-
● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ●
ically ill patients.
DOI: 10.2337/dc10-S003 ●
© 2010 by the American Diabetes Association. Readers may use this article as long as the work is properly
The section “Strategies for improving
cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons. diabetes care” has been extensively re-
org/licenses/by-nc-nd/3.0/ for details. vised to reflect newer evidence.
care.diabetesjournals.org DIABETES CARE, VOLUME 33, SUPPLEMENT 1, JANUARY 2010 S3