The American Diabetes Association (ADA) has published standards of care for diabetes management, emphasizing the need for ongoing medical care and patient education to prevent acute and long-term complications. These standards provide guidelines for clinicians, patients, researchers, and payors, covering components of care, treatment goals, and quality evaluation tools. The standards are revised annually and incorporate new evidence. **Classification and Diagnosis:** - Diabetes is classified into four types: Type 1 (insulin deficiency), Type 2 (insulin resistance), other specific types (e.g., genetic defects), and gestational diabetes (GDM). - Diagnosis is based on plasma glucose criteria (fasting plasma glucose [FPG] and 2-hour oral glucose tolerance test [OGTT]) or HbA1c levels. The ADA recommends using HbA1c for diagnosis with a threshold of ≥6.5%. - Individuals with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) are at high risk for developing diabetes and should be counseled on lifestyle changes and monitored regularly. **Testing for Diabetes:** - Testing is recommended for asymptomatic adults who are overweight or obese (BMI ≥25 kg/m²) and have additional risk factors. Testing should start at age +5 years without risk factors. - A1C, FPG, or 2-hour OGTT can be used for testing. The 2-hour OGTT is more effective in identifying individuals at risk for diabetes and cardiovascular disease (CVD). **Prevention and Delay of Type 2 Diabetes:** - Individuals with IGT, IFG, or an A1C of 5.7–6.4% should be referred to a support program for weight loss and increased physical activity. - Lifestyle interventions and metformin are recommended for high-risk individuals to prevent the onset of diabetes. **Diabetes Care:** - Comprehensive evaluation and management should be coordinated by a multidisciplinary team, including physicians, nurses, dietitians, and mental health professionals. - Glycemic control is assessed through self-monitoring of blood glucose (SMBG) or HbA1c. SMBG is recommended for patients using multiple insulin injections or insulin pump therapy. - HbA1c should be measured at least twice a year for patients meeting treatment goals and quarterly for those not meeting goals. - Glycemic goals for nonpregnant adults are <7%, with potential for lower targets in selected patients without significant hypoglycemia or adverse effects. **Gestational Diabetes Mellitus (GDM):** - GDM should be screened using risk factor analysis and an OGTT if appropriate. - Women with GDM should be screened for diabetes 6–12 weeks postpartum and followed for the development of diabetes or pre-diabetes. These standards aim to provide a comprehensive framework for the management of diabetes, emphasizing the importance of early detection, lifestyle interventions, and ongoing monitoringThe American Diabetes Association (ADA) has published standards of care for diabetes management, emphasizing the need for ongoing medical care and patient education to prevent acute and long-term complications. These standards provide guidelines for clinicians, patients, researchers, and payors, covering components of care, treatment goals, and quality evaluation tools. The standards are revised annually and incorporate new evidence. **Classification and Diagnosis:** - Diabetes is classified into four types: Type 1 (insulin deficiency), Type 2 (insulin resistance), other specific types (e.g., genetic defects), and gestational diabetes (GDM). - Diagnosis is based on plasma glucose criteria (fasting plasma glucose [FPG] and 2-hour oral glucose tolerance test [OGTT]) or HbA1c levels. The ADA recommends using HbA1c for diagnosis with a threshold of ≥6.5%. - Individuals with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) are at high risk for developing diabetes and should be counseled on lifestyle changes and monitored regularly. **Testing for Diabetes:** - Testing is recommended for asymptomatic adults who are overweight or obese (BMI ≥25 kg/m²) and have additional risk factors. Testing should start at age +5 years without risk factors. - A1C, FPG, or 2-hour OGTT can be used for testing. The 2-hour OGTT is more effective in identifying individuals at risk for diabetes and cardiovascular disease (CVD). **Prevention and Delay of Type 2 Diabetes:** - Individuals with IGT, IFG, or an A1C of 5.7–6.4% should be referred to a support program for weight loss and increased physical activity. - Lifestyle interventions and metformin are recommended for high-risk individuals to prevent the onset of diabetes. **Diabetes Care:** - Comprehensive evaluation and management should be coordinated by a multidisciplinary team, including physicians, nurses, dietitians, and mental health professionals. - Glycemic control is assessed through self-monitoring of blood glucose (SMBG) or HbA1c. SMBG is recommended for patients using multiple insulin injections or insulin pump therapy. - HbA1c should be measured at least twice a year for patients meeting treatment goals and quarterly for those not meeting goals. - Glycemic goals for nonpregnant adults are <7%, with potential for lower targets in selected patients without significant hypoglycemia or adverse effects. **Gestational Diabetes Mellitus (GDM):** - GDM should be screened using risk factor analysis and an OGTT if appropriate. - Women with GDM should be screened for diabetes 6–12 weeks postpartum and followed for the development of diabetes or pre-diabetes. These standards aim to provide a comprehensive framework for the management of diabetes, emphasizing the importance of early detection, lifestyle interventions, and ongoing monitoring