New ADA Standards: Promoting Health

This transcript has been edited for clarity.

Today I'm going to discuss the 2020 American Diabetes Association (ADA) Standards of Medical Care in Diabetes. I was part of the committee that wrote these standards of care. This committee consisted of incredibly hard-working, smart people, and it was an honor to work with them.

We had some hiccups along the way, but we continued to do the best we could with the available evidence to move our standards of care and recommendations forward. The ADA standards don't change significantly from year to year; rather, there are incremental changes based on the evidence.

If you're not familiar with the grading of evidence, level A evidence is the highest-quality data from randomized controlled trials (RCTs) and meta-analyses. Less rigorous evidence is ranked from B to E, with level E evidence being expert opinion—what we experts think is the best way to manage our patients in the absence of RCT data.

As you go through the guidelines, you'll see that the quality of evidence varies. In some areas, we have a lot of evidence, but in other areas—particularly with devices—much of the evidence is level E because it reflects what we've been doing in practice rather than data from RCTs.