Standards ofMedical Care in

D iabetes mellitus is a chronic illnessthat requires continuing medical careand ongoing patient self-management education and support to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that sup-ports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payers, and other interested individuals with the components of diabetes care, general treatment goals, and tools to eval-uate the quality of care. While individual preferences, comorbidities, and other pa-tient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. Spe-cifically titled sections of the standards address children with diabetes, pregnant women, and people with prediabetes. These standards are not intended to preclude clinical judgment or more extensive eval-uation and management of the patient by other specialists as needed. For more de-tailed information about management of diabetes, refer to references 1–3. The recommendations included are screening, diagnostic, and therapeutic ac-tions that are known or believed to favor-ably affect health outcomes of patients with diabetes. A large number of these interven-tions have been shown to be cost-effective (4). A grading system (Table 1), developed by the American Diabetes Association (ADA) andmodeled after existingmethods, was utilized to clarify and codify the evi-dence that forms the basis for the recom-mendations. The level of evidence that supports each recommendation is listed af-ter each recommendation using the letters A, B, C, or E. These standards of care are revised an-nually by the ADA’s multidisciplinary Pro-fessional Practice Committee, incorporating new evidence. For the current revision, committee members systematically searched Medline for human studies related to each subsection and published since 1 Januar