ADA updates its “living" guidelines based on CREDENCE trial

  • American Diabetes Association

  • International Clinical Digest
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Takeaway

  • The American Diabetes Association (ADA) has updated 2 sections in its online “Living” Standards of Medical Care, based on the recently reported Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy (CREDENCE) trial results.  

Renal Management Guidelines Update

  • Section 11, on Microvascular Complications and Foot Care, now includes the following recommendations (graded A, B, C):
    • 11.1 At least once yearly, assess urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate (eGFR) in patients with type 1 diabetes with duration of ≥5 years, in all patients with type 2 diabetes (T2D), regardless of treatment, and in all patients with comorbid hypertension. B
    • 11.3 For patients with T2D and diabetic kidney disease, consider use of a sodium-glucose cotransporter 2 inhibitor in patients with eGFR ≥30, particularly in those with >300 mg/g albuminuria to reduce risk of chronic kidney disease (CKD) progression, cardiovascular events, or both. A
    • 11.3 In patients with CKD at increased risk for cardiovascular events, use of a glucagon-like peptide-1 receptor agonist may reduce risk of progression of albuminuria, cardiovascular events, or both. C
  • Section 10, Cardiovascular Disease and Risk Management:
    • Now includes information about CREDENCE and CANVAS.
    • Section was endorsed by the American College of Cardiology.

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