American Diabetes Association 2010 guidelines – evolution or revolution? Review article
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Abstract
American Diabetes Association publish their clinical guidelines yearly, and they usually form foundations for the guidelines prepared by various global (like WHO) and local clinical and/or scientific associations or expert groups including Diabetes Poland. In 2010 ADA introduced new criterion for diagnosing diabetes (glycated hemoglobin HbA1c ≥6.5%) and glucose intolerance (HbA1c 5.7–6.4%, prediabetes). Moreover, new recommendations for acetylsalicylic acid (it should be prescribed only to those at high risk of cardiovascular disease) and in-hospital glucose control in severely ill patients (target blood glucose 140–180 mg/dl) were given. Wide adoption of HbA1c for diabetes diagnosis will meet with controversies as laboratory methods for HbA1c assessment should be standardized, the cost of HbA1c measurements is much higher than glucose assessment, and – last but not least – sensitivity of HbA1c 6.5% seems to be low (30–40%). Other changes introduced by the ADA in 2010 will probably be promptly accepted by expert groups in many countries.
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