3. Prevention or Delay of Type 2 Diabetes: Standards of Medical Care in Diabetes-2021

The American Diabetes Association (ADA) Standards of Medical Care in Diabetes includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multi-disciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, ormore frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading systemforADA's clinicalpractice recommendations, please refer to the Standardsof Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. For guidelines related to screening for increased risk for type 2 diabetes (prediabetes), please refer to Section 2 Classification and Diagnosis of Diabetes (https://doi.org/10.2337/dc21-S002). For guidelines related to screening, diagnosis, and management of type 2 diabetes in youth, please refer to Section 13 Children and Adolescents (https://doi.org/10.2337/dc21-S013). Recommendation 3.1 At least annual monitoring for the development of type 2 diabetes in those with prediabetes is suggested. E Screening for prediabetes and type 2 diabetes risk through an informal assessment of risk factors (Table 2.3) or with an assessment tool, such as the American Diabetes Association risk test (Fig. 2.1), is recommended to guide providers on whether performing a diagnostic test for prediabetes (Table 2.5) and previously undiagnosed type 2 diabetes (Table2.2) is appropriate (see Section2ClassificationandDiagnosis of Diabetes, https:// doi.org/10.2337/dc21-S002). Testing high-risk patients for prediabetes is warranted because the laboratory assessment is safe and reasonable in cost, substantial time exists before the development of type 2 diabetes and its complications during which one can intervene, and there is an effective means of preventing type 2 diabetes in those determined to have prediabetes with an A1C 5.7-6.4% (39-47 mmol/mol), impaired glucose tolerance, or impaired fasting glucose. Using A1C to screen forprediabetesmaybe problematic in the presence of certain hemoglobinopathies or conditions that affect red bloodcell turnover. SeeSection2ClassificationandDiagnosisofDiabetes (https://doi.org/10.2337/dc21-S002) andSection6Glycemic Targets (https://care.diabetesjournals.org/lookup/doi/10.2337/dc21-S006) for additional details on the appropriate use of the A1C test.

Automated summary

The American Diabetes Association's Standards of Medical Care in Diabetes consist of clinical practice recommendations, components of diabetes care, and tools for evaluating quality of care. The committee is responsible for updating the standards annually, and monitoring for the development of type 2 diabetes in those with prediabetes is suggested. Screening for prediabetes in high-risk patients is recommended as it provides an effective means of preventing type 2 diabetes.