Diabetes treatment goals are to prevent or delay complications and optimize quality of life. These goals should be developed collaboratively with people with diabetes to honor their preferences and values. Comprehensive diabetes care should be provided by an interprofessional team that may include but is not limited to diabetes care and education specialists, primary care and subspecialty clinicians, nurses, registered dietitian nutritionists, exercise specialists, pharmacists, dentists, podiatrists, behavioral health professionals, and community partners such as community health workers and community paramedics. Ongoing treatment necessitates regular follow-up and the active engagement of people with diabetes and their care partners. Comprehensive medical evaluations (described in the table on the last 2 pages of this document) and the provision of all recommended vaccinations (cdc.gov/vaccines) are essential components of ongoing diabetes care.
Assessment of Comorbidities
Optimizing Bone Health in People With Diabetes
| Are people with diabetes at increased risk for cancer? |
|---|
 Diabetes is associated with increased risks of cancers of the liver, pancreas, endometrium, colon and rectum, breast, and bladder. Nevertheless, cancer screening recommendations are the same for people with diabetes as for those without diabetes. |
| Are people with diabetes at increased risk for cancer? |
|---|
| Diabetes is associated with increased risks of cancers of the liver, pancreas, endometrium, colon and rectum, breast, and bladder. Nevertheless, cancer screening recommendations are the same for people with diabetes as for those without diabetes. |
How prevalent is metabolic dysfunction–associated steatotic liver disease (MASLD)? Who should be screened for it and how?
Diagnostic Algorithm for the Prevention of Cirrhosis in People With MASLD
CV, cardiovascular; ELF, enhanced liver fibrosis test; LSM, liver stiffness measurement, as measured by vibration-controlled transient elastography.
*In the absence of LSM, consider ELF a diagnostic alternative. If ELF ≥9.8, an individual is at high risk of MASLD with advanced liver fibrosis (≥F3–F4) and should be referred to a liver specialist.
CV, cardiovascular; ELF, enhanced liver fibrosis test; LSM, liver stiffness measurement, as measured by vibration-controlled transient elastography.
*In the absence of LSM, consider ELF a diagnostic alternative. If ELF ≥9.8, an individual is at high risk of MASLD with advanced liver fibrosis (≥F3–F4) and should be referred to a liver specialist.
Components of the Comprehensive Diabetes Medical Evaluation at Initial, Follow-Up, and Annual Visits
ABI, ankle-brachial index; ARBs, angiotensin receptor blockers; CBC, complete blood count; CGM, continuous glucose monitor; FIB-4, fibrosis-4 index; MASLD, metabolic-associated steatotic liver disease; MDI, multiple daily injections; OSA, obstructive sleep apnea; PAD, peripheral arterial disease.
*Should be performed at every visit in people with diabetes with sensory loss, previous foot ulcers, or amputations.
†At 65 years of age or older.
‡May also need to be checked after initiation or dose changes of medications that affect these laboratory values (i.e., diabetes medications, blood pressure medications, cholesterol medications, or thyroid medications).
^In people without dyslipidemia and not on cholesterol-lowering therapy, testing may be less frequent.
§May be needed more frequently in people with diabetes with known chronic kidney disease or with changes in medications that affect kidney function and serum potassium.
ǁIn people with presence of gastrointestinal symptoms, signs, laboratory manifestations, or clinical suspicion suggestive of celiac disease.
ABI, ankle-brachial index; ARBs, angiotensin receptor blockers; CBC, complete blood count; CGM, continuous glucose monitor; FIB-4, fibrosis-4 index; MASLD, metabolic-associated steatotic liver disease; MDI, multiple daily injections; OSA, obstructive sleep apnea; PAD, peripheral arterial disease.
*Should be performed at every visit in people with diabetes with sensory loss, previous foot ulcers, or amputations.
†At 65 years of age or older.
‡May also need to be checked after initiation or dose changes of medications that affect these laboratory values (i.e., diabetes medications, blood pressure medications, cholesterol medications, or thyroid medications).
^In people without dyslipidemia and not on cholesterol-lowering therapy, testing may be less frequent.
§May be needed more frequently in people with diabetes with known chronic kidney disease or with changes in medications that affect kidney function and serum potassium.
ǁIn people with presence of gastrointestinal symptoms, signs, laboratory manifestations, or clinical suspicion suggestive of celiac disease.
