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)

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Abstract

The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the previous consensus statements on the management of hyperglycaemia in type 2 diabetes in adults, published since 2006 and last updated in 2019. The target audience is the full spectrum of the professional healthcare team providing diabetes care in the USA and Europe. A systematic examination of publications since 2018 informed new recommendations. These include additional focus on social determinants of health, the healthcare system and physical activity behaviours including sleep. There is a greater emphasis on weight management as part of the holistic approach to diabetes management. The results of cardiovascular and kidney outcomes trials involving sodium–glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, including assessment of subgroups, inform broader recommendations for cardiorenal protection in people with diabetes at high risk of cardiorenal disease. After a summary listing of consensus recommendations, practical tips for implementation are provided.

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Supplementary Information

The online version of this article (10.1007/s00125-022-05787-2) contains peer-reviewed but unedited supplementary material.

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Most cited references 330

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Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

Bernard Zinman, Christoph Wanner, John M. Lachin … (2015)

The effects of empagliflozin, an inhibitor of sodium-glucose cotransporter 2, in addition to standard care, on cardiovascular morbidity and mortality in patients with type 2 diabetes at high cardiovascular risk are not known.

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World Health Organization 2020 guidelines on physical activity and sedentary behaviour

Fiona Bull, Salih Al-Ansari, Stuart Biddle … (2020)

Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.

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Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction

John J.V. McMurray, Scott D. Solomon, Silvio E Inzucchi … (2020)

In patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes.

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Author and article information

Contributors

Melanie J. Davies:

ORCID: https://orcid.org/0000-0002-9987-9371

melanie.davies@uhl-tr.nhs.uk

John B. Buse:

ORCID: https://orcid.org/0000-0002-9723-3876

jbuse@med.unc.edu

Journal

Journal ID (nlm-ta): Diabetologia

Journal ID (iso-abbrev): Diabetologia

Title: Diabetologia

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0012-186X

ISSN (Electronic): 1432-0428

Publication date (Electronic): 24 September 2022

Pages: 1-42

Affiliations

[1 ]GRID grid.9918.9, ISNI 0000 0004 1936 8411, Leicester Diabetes Research Centre, , University of Leicester, ; Leicester, UK

[2 ]GRID grid.269014.8, ISNI 0000 0001 0435 9078, Leicester National Institute for Health Research (NIHR) Biomedical Research Centre, , University Hospitals of Leicester NHS Trust, ; Leicester, UK

[3 ]GRID grid.38142.3c, ISNI 000000041936754X, Division of Endocrinology, Diabetes and Hypertension, , Brigham and Women’s Hospital, Harvard Medical School, ; Boston, MA USA

[4 ]GRID grid.279885.9, ISNI 0000 0001 2293 4638, National Heart, Lung, and Blood Institute, ; Bethesda, MD USA

[5 ]GRID grid.454228.d, ADA, ; Arlington, VA USA

[6 ]GRID grid.26009.3d, ISNI 0000 0004 1936 7961, Duke Clinical Research Institute, , Duke University School of Medicine, ; Durham, NC USA

[7 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Department of Medicine, , Johns Hopkins University School of Medicine, ; Baltimore, MD USA

[8 ]GRID grid.38142.3c, ISNI 000000041936754X, Kidney and Hypertension Unit, Joslin Diabetes Center, Harvard Medical School, ; Boston, MA USA

[9 ]GRID grid.5395.a, ISNI 0000 0004 1757 3729, Department of Clinical and Experimental Medicine, , University of Pisa, ; Pisa, Italy

[10 ]GRID grid.5596.f, ISNI 0000 0001 0668 7884, Clinical and Experimental Endocrinology, , KU Leuven, ; Leuven, Belgium

[11 ]GRID grid.8142.f, ISNI 0000 0001 0941 3192, Università Cattolica del Sacro Cuore, ; Rome, Italy

[12 ]GRID grid.414603.4, Fondazione Policlinico Universitario A. Gemelli IRCCS, ; Rome, Italy

[13 ]GRID grid.13097.3c, ISNI 0000 0001 2322 6764, Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, , King’s College London, ; London, UK

[14 ]GRID grid.419658.7, ISNI 0000 0004 0646 7285, Steno Diabetes Center Copenhagen, ; Herlev, Denmark

[15 ]GRID grid.5254.6, ISNI 0000 0001 0674 042X, Department of Clinical Medicine, , University of Copenhagen, ; Copenhagen, Denmark

[16 ]GRID grid.410563.5, ISNI 0000 0004 0621 0092, Department of Endocrinology, Medical University – Sofia, ; Sofia, Bulgaria

[17 ]GRID grid.4793.9, ISNI 0000000109457005, Diabetes Centre, Clinical Research and Evidence-based Medicine Unit, , Aristotle University Thessaloniki, ; Thessaloniki, Greece

[18 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Harris Manchester College, , University of Oxford, ; Oxford, UK

[19 ]GRID grid.10698.36, ISNI 0000000122483208, University of North Carolina School of Medicine, ; Chapel Hill, NC USA

Author information

Melanie J. Davies https://orcid.org/0000-0002-9987-9371

Vanita R. Aroda https://orcid.org/0000-0002-7706-4585

Billy S. Collins https://orcid.org/0000-0002-5271-3534

Robert A. Gabbay https://orcid.org/0000-0003-3541-1486

Jennifer Green https://orcid.org/0000-0002-5061-9632

Nisa M. Maruthur https://orcid.org/0000-0002-5799-104X

Sylvia E. Rosas https://orcid.org/0000-0002-9903-4002

Stefano Del Prato https://orcid.org/0000-0002-5388-0270

Chantal Mathieu https://orcid.org/0000-0002-4055-5233

Geltrude Mingrone https://orcid.org/0000-0003-2021-528X

Peter Rossing https://orcid.org/0000-0002-1531-4294

Tsvetalina Tankova https://orcid.org/0000-0002-7572-1131

Apostolos Tsapas https://orcid.org/0000-0003-0221-4072

John B. Buse https://orcid.org/0000-0002-9723-3876

Article

Publisher ID: 5787

DOI: 10.1007/s00125-022-05787-2

PMC ID: 9510507

PubMed ID: 36151309

SO-VID: 7ff719dc-c0c2-4222-9916-833bc534ff18

Copyright © © American Diabetes Association and the European Association for the Study of Diabetes 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

History

Date received : 2 August 2022

Date accepted : 18 August 2022

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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)

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Abstract

Graphical abstract

Supplementary Information

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Cardiovascular Innovations and Applications

Most cited references 330

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

World Health Organization 2020 guidelines on physical activity and sedentary behaviour

Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction

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Cited by 142

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