ADA updates its “living” standards of medical care in DM

  • American Diabetes Association

  • Miriam Tucker
  • Clinical Essentials
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Takeaway

  • The American Diabetes Association (ADA) has updated its “Living” 2019 Standards of Medical Care in Diabetes.
  • Updates are based on newly published data and FDA label change affecting care for patients with diabetes mellitus (DM) who also have cardiovascular disease and/or chronic kidney disease (CKD).

The updates are:

  • Section 10 was updated based on the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT), in which icosapent ethyl (Vascepa) added to statin therapy for patients with high triglyceride levels reduced cardiovascular events.
    • Standards now include a recommendation that icosapent ethyl be considered for patients with diabetes and atherosclerotic cardiovascular disease or other cardiac risk factors on a statin with controlled low-density lipoprotein cholesterol, but with elevated triglycerides (135-499 mg/dL) to reduce cardiovascular risk.
  • Several revisions in sections 9, 10, and 11 were based on outcomes from The Dapagliflozin Effect on Cardiovascular Events-Thrombosis in Myocardial Infarction 58 (DECLARE-TIMI 58) Trial, in which dapagliflozin (Farxiga) reduced both hospitalization for heart failure and CKD progression.
  • Based on a revision to dapagliflozin prescribing information for patients with diabetes and CKD, the approved use per estimated glomerular filtration rate has been revised from ≥60 mL/minute/1.73 m2 to ≥45 mL/minute/1.73 m2 in Section 11.