Treatment Approach

The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia.

New abridged recommendations

The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers, highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects:

  • Prediabetes

  • Self-management education

  • Nutrition

  • Physical activity

  • Smoking cessation

  • Psychosocial care

  • Immunizations

  • Glycemic treatment

  • Therapeutic targets

  • Diagnosis and treatment of vascular complications

  • Intensification of insulin therapy in type 2 diabetes