American Diabetes Association, EASD Update Recommendations on Hyperglycemia Management in Type 2 Diabetes

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) have announced the release of a new consensus update on the management of hyperglycemia in type 2 diabetes.

Released on September 23, the 42-page document has a target audience described as the “full spectrum of professional healthcare team providing diabetes care” and provides updates to recommendations made in previous consensus reports from the organizations released in 2018 and 2019.

“We are excited to share an updated consensus report on the management of hyperglycemia in type 2 diabetes,” said Robert Gabbay, MD, PhD, chief scientific and medical officer for the ADA, in a statement. “This is a wide-ranging consensus report that has several new features. It not only speaks of what needs to be done, but it also has a section on how to implement those changes.”

Led by John Buse, MD, PhD, of the University of North Caroline School of Medicine, and Melanie Davies, CBE, MBChB, MD, of the Leicester Diabetes Centre, the consensus report was composed by a multidisciplinary team of experts representing major institutions from across the US and Europe. A draft version of the report was presented and the opportunity for feedback was provided at the ADA’s 82nd Scientific Session in June 2022. In the aforementioned statement, the ADA press team noted that suggested changes from this feedback period included a greater focus on person-centered care, equity of care, and weight loss management.

Citing more than 340 references, the consensus report was aimed at encapsulating the recent explosion in knowledge and management strategies since the last update was published in 2019. Among the updates highlighted by the ADA were recommendations on use of oral GLP-1 RAs, the GIP/GLP-1 RA class, and combination therapy with GLP-1 RA and insulin. The document also provides information related to glucose-lowering therapies based on the presence of different comorbid conditions.

The document also includes a particular focus on lifestyle modifications and cites a multitude of lifestyle recommendations, including light exercise or resistance training every 30 minutes while sitting, achieving an extra 500 daily steps, reaching the 150-minute threshold of moderate to vigorous physical activity each week, strength training 2-3 times per week, and getting between 6-9 hours of sleep each night.

The entirety of page of 3 of the consensus report is dedicated to a graphic emphasizing the decision cycle for glycemic management in type 2 diabetes, from specific factors that impact treatment choices to ongoing support and monitoring strategies. This is the first of 6 dedicated pages with graphics, chart, or diagrams highlighting specifics aspects of care and diabetes management, including a summary of characteristics for glucose-lowering medications, optimal approaches for holistic person-centered type 2 diabetes management, and recommendations for initiating insulin therapy.

This consensus report, “Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD),” was copublished in Diabetes Care and Diabetologia.