Diabetes Q&A

AACE/ACE Publishes Diabetes Management Algorithm

The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) have developed a practical, easy-to-use algorithm for managing patients with type 2 diabetes.

The algorithm is color-coded with arrows that show treatment pathways. It was designed to simplify the management of diabetes for non-expert clinicians who need practical, pragmatic guidance as they see their patients.

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This algorithm is updated annually in January; this system allows the task force to make frequent changes as their knowledge expands.

To construct the 2017 algorithm, the task force of 20 clinical experts distilled current knowledge in the field and used their judgment and experience for areas that lacked evidence.

The algorithm, which supplements the AACE/ACE 2015 Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan, emphasizes obesity as an underlying risk factor for diabetes and its microvascular complications. It also focuses on cardiovascular risk factors and treatment recommendations based on a patient’s risk profile.

The updated algorithm provides recommendations in many areas, including lifestyle therapy, obesity, diabetes pharmacotherapy, insulin use, blood pressure, and lipids.

One recommendation of note is that all patients who are overweight or obese and have prediabetes or diabetes should be prescribed a lifestyle therapy of a reduced-calorie diet, increased physical activity, and behavioral intervention. Weight loss medications are only recommended if lifestyle therapy fails to attain prediabetes or diabetes therapeutic goals.

—Amanda Balbi

Reference:

Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm – 2017 executive summary. Endocr Pract. 2017;23(2):207-238. doi:10.4158/EP161682.CS.