Medical Practice Guidelines

Standards of Care

Diabetes is a chronic illness that requires continuing medical care and education to prevent acute complications and to reduce the risk of long-term complications. People with diabetes should receive their treatment and care from a physician-coordinated team. Such teams include, but are not limited to, physicians, nurses, dietitians, and mental health professionals with expertise and a special interest in diabetes.

The following standards define basic medical care for people with diabetes. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed.

These standards of diabetes care seek to provide:
1. Physicians and other health care professionals who treat people with diabetes with a means to
	Set treatment goals
	Assess the quality of diabetes treatment provided
	Identify areas where more attention or self-management training is needed
	Define timely and necessary referral patterns to appropriate specialists
2. People with diabetes with a means to
	Assess the quality of medical care they receive
	Develop expectations for their role in the medical treatment
	Compare their treatment outcomes with standard goals

Achieving near normal or normal blood glucose levels in patients requires comprehensive education in self-management and, for most individuals, intensive treatment programs. Such programs include the following components according to individual patient need:
	Appropriate frequency of self-monitoring of blood glucose (SMBG)
	Medical nutrition therapy (MNT)
	Regular exercise
	Physiologically based insulin regimens, i.e., multiple daily injections of rapid-acting insulin analogs (e.g., lispro), short-acting (e.g., regular), intermediate-acting (e.g., NPH or lente), or long-acting (e.g., ultralente) insulins or continuous subcutaneous insulin infusion, in type 1 and some type 2 patients
	Less-complex insulin regimens or oral glucose-lowering agents in some type 2 patients
	Instruction in the prevention and treatment of hypoglycemia and other acute and chronic complications
	Continuing education and reinforcement
	Periodic assessment of treatment goals

To be effective, treatment programs require ongoing support from the clinical care team.