Professional Practice Committee: Standards of Medical Care in Diabetes—2020

The Professional Practice Committee (PPC) of the American Diabetes Association (ADA) is responsible for the “Standards of Medical Care in Diabetes,” referred to as the Standards of Care. The PPC is a multidisciplinary expert committee comprised of physicians, diabetes educators, and others who have expertise in a range of areas, including, but not limited to, adult and pediatric endocrinology, epidemiology, public health, cardiovascular risk management, microvascular complications, preconception and pregnancy care, weight management and diabetes prevention, and use of technology in diabetes management. Appointment to the PPC is based on excellence in clinical practice and research. Although the primary role of the PPC members is to review and update the Standards of Care, they may also be involved in ADA statements, reports, and reviews.

The ADA adheres to the National Academy of Medicine Standards for Developing Trustworthy Clinical Practice Guidelines. All members of the PPC are required to disclose potential conflicts of interest with industry and other relevant organizations. These disclosures are discussed at the onset of each Standards of Care revision meeting. Members of the committee, their employers, and their disclosed conflicts of interest are listed in “Disclosures: Standards of Medical Care in Diabetes—2020” (https://doi.org/10.2337/dc20-SPPC). The ADA funds development of the Standards of Care out of its general revenues and does not use industry support for this purpose.

For the current revision, PPC members systematically searched MEDLINE for human studies related to each section and published since 15 October 2018. Due to limitations associated with production timelines, evidence published in late 2019 was not incorporated into the initial 2020 Standards of Care release (e.g., Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction [DAPA-HF], Cardiovascular Outcome Study of Linagliptin Versus Glimepiride in Patients With Type 2 Diabetes [CAROLINA], etc.), but salient new data will be incorporated in a living Standards update in early 2020 (professional.diabetes.org/content-page/living-standards). Recommendations were revised based on new evidence or, in some cases, to clarify the prior recommendation or match the strength of the wording to the strength of the evidence. A table linking the changes in recommendations to new evidence can be reviewed online at professional.diabetes.org/SOC. The Standards of Care is approved by the ADA’s Board of Directors, which includes health care professionals, scientists, and lay people.

Feedback from the larger clinical community was invaluable for the annual 2019 revision of the Standards of Care. Readers who wish to comment on the 2020 Standards of Care are invited to do so at professional.diabetes.org/SOC.

The PPC thanks the following individuals who provided their expertise in reviewing and/or consulting with the committee: Nidhi Bansal, MD; Linda A. Barbour, MD, MSPH, FACP; Florence Brown, MD; Thomas Buchanan, MD; Linda A. DiMeglio, MD; Alison B. Evert, MS, RD, CDE; Hermes Flores, MD, PhD; Thomas W. Gardner, MD, MS; Rose Gubitosi-Klug, MD, PhD; William C. Hsu, MD; Sally C. Hughes, BA; Scott Kahan, MD, MPH; Ka Hei Karen Lau, MS, RD, LDN, CDE; Jose Leon, MD; Ingrid Libman, MD, PhD; Sarah K. Lyons, MD; Medha Munshi, MD; Henry Rodriguez, MD; Amy Shah, MD; Connor K. Smith, BS; Andrea Steck, MD; William S. Yancy, MD, MHS; and Ann Zmuda, DPM.