Funded out Association’s general revenues and does not use industry support. Funded out Association’s general revenues and does not use industry support

Funded out Association’s general revenues and does not use industry support.

• Funded out Association’s general revenues and does not use industry support.

• Slides correspond with sections within the Standards of Medical Care in Diabetes - 2017.

• Reviewed and approved by the Association’s Board of Directors.

ADA’s Professional Practice Committee (PPC) conducts annual review & revision.

• ADA’s Professional Practice Committee (PPC) conducts annual review & revision.

• Searched Medline for human studies related to each subsection and published since January 1, 2016.

• Recommendations revised per new evidence, for clarity, or to better match text to strength of evidence.

• Professional.diabetes.org/SOC

Members of the PPC

• Members of the PPC

• William H. Herman, MD, MPH (Co-Chair)

• Rita R. Kalyani, MD, MHS, FACP (Co-Chair)

• Andrea L. Cherrington, MD, MPH

• Donald R. Coustan, MD

• Ian de Boer, MD, MS

• Robert James Dudl, MD

• Hope Feldman, CRNP, FNP-BC

• Hermes J. Florez, MD, PhD, MPH

• Suneil Koliwad, MD, PhD

• Melinda Maryniuk, MEd, RD, CDE

• Joshua J. Neumiller, PharmD, CDE, FASCP

• Joseph Wolfsdorf, MB, BCh

Treatment decisions should be timely and based on evidence-based guidelines that are tailored to patient preferences, prognoses, and comorbidities. B

• Treatment decisions should be timely and based on evidence-based guidelines that are tailored to patient preferences, prognoses, and comorbidities. B

• Providers should consider the burden of treatment and self-efficacy of patients when recommending treatments. E

Treatment plans should align with Chronic Care Model, emphasizing productive interactions between a prepared proactive practice team and an informed activated patient. A

• Treatment plans should align with Chronic Care Model, emphasizing productive interactions between a prepared proactive practice team and an informed activated patient. A

• When feasible, care systems should support team-based care, community involvement, patient registries, and decision support tools to meet patient needs. B

33-49% of patients still do not meet targets for A1C, blood pressure, or lipids.

• 33-49% of patients still do not meet targets for A1C, blood pressure, or lipids.

• 14% meet targets for all A1C, BP, lipids, and nonsmoking status.

• Progress in CVD risk factor control is slowing.

• Substantial system-level improvements are needed.

• Delivery system is fragmented, lacks clinical information capabilities, duplicates services & is poorly designed.

Six Core Elements:

• Six Core Elements:

• Delivery system design

• Self-management support

• Decision support

• Clinical information systems

• Community resources & policies

• Health systems

• Three Key Objectives

• Optimize Provider and Team Behavior

• Support Patient Self-Management

• Change the Care System

For patients who have not achieved beneficial levels of control in blood pressure, lipids, or glucose, the care team should prioritize timely & appropriate intensification of lifestyle and/or pharmaceutical therapy.

• For patients who have not achieved beneficial levels of control in blood pressure, lipids, or glucose, the care team should prioritize timely & appropriate intensification of lifestyle and/or pharmaceutical therapy.

• Strategies include:

• Explicit goal setting with patients
• Identifying and addressing language, numeracy, and/or cultural barriers to care
• Integrating evidence-based guidelines
• Incorporating care management teams

Implement a systematic approach to support patient behavior change efforts, including:

• Implement a systematic approach to support patient behavior change efforts, including:

• Healthy lifestyle
• Disease self-management
• Prevention of diabetes complications
• Identification of self-management problems and development of strategies to solve those problems

Successful practices prioritize providing a high quality of care. Changes that have been shown to increase quality of care include:

• Successful practices prioritize providing a high quality of care. Changes that have been shown to increase quality of care include:

• Basing care on evidence-based guidelines
• Expanding the role of teams to implement more intensive disease management strategies
• Redesigning the care process
• Implementing electronic health record tools
• Activating and educating patients