ADA糖尿病指南-2022StandardsofMedicalCareinDiabetes—2022AMERICANDIABETESASSOCIATIONDiabetesisachronicillnessthatre-quirescontinuingmedicalcareandongoingpatientself-managementeducationandsupporttopreventacutecomplicationsandtoreducetheriskoflong-termcomplications.Diabetescareiscomplexandrequiresthatmanyissues,beyondglycemiccontrol,beaddressed.Alargebodyofevidenceexiststhatsup-portsarangeofinterventionstoimprovediabetesoutcomes.Thesestandardsofcareareintendedtoprovideclinicians,patients,research-ers,payors,andotherinterestedindivid-ualswiththecomponentsofdiabetescare,generaltreatmentgoals,andtoolstoevaluatethequalityofcare.Whileindi-vidualpreferences,comorbidities,andotherpatientfactorsmayrequiremodi?-cationofgoals,targetsthataredesirableformostpatientswithdiabete---本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---sarepro-vided.Thesestandardsarenotintendedtoprecludeclinicaljudgmentormoreex-tensiveevaluationandmanagementofthepatientbyotherspecialistsasneeded.Formoredetailedinformationaboutmanage-mentofdiabetes,refertoreferences1–3.Therecommendationsincludedarescreening,diagnostic,andtherapeuticac-tionsthatareknownorbelievedtofavor-ablyaffecthealthoutcomesofpatientswithdiabetes.Agradingsystem(Table1),developedbytheAmericanDiabetesAs-sociation(ADA)andmodeledafterexist-ingmethods,wasusedtoclarifyandcodifytheevidencethatformsthebasisfortherecommendations.Thelevelofev-idencethatsupportseachrecommenda-tionislistedaftereachrecommendationusingthelettersA,B,C,orE.ThesestandardsofcarearerevisedannuallybytheADAmultidisciplinaryProfessionalPracticeCommittee,andnewevidenceisincorporated.MembersoftheProfessionalPracticeCommitteeandtheirdisclosedcon?ictsofinterestarelistedintheIntroduction.Subsequently,aswithallpositionstatements,thestan----本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---dardsofcarearereviewedandapprovedbytheExecutiveCommitteeofADA’sBoardofDirectors.I.CLASSIFICATIONANDDIAGNOSISA.Classi?cationTheclassi?cationofdiabetesincludesfourclinicalclasses:●type1diabetes(resultsfrom?-cellde-struction,usuallyleadingtoabsoluteinsulinde?ciency)●type2diabetes(resultsfromaprogres-siveinsulinsecretorydefectonthebackgroundofinsulinresistance)●otherspeci?ctypesofdiabetesduetoothercauses,e.g.,geneticdefectsin?-cellfunction,geneticdefectsininsu-linaction,diseasesoftheexocrinepan-creas(suchascystic?brosis),anddrug-orchemical-induceddiabetes(suchasinthetreatmentofAIDSorafterorgantransplantation)●gestationaldiabetesmellitus(GDM)(diabetesdiagnosedduringpregnancy)Somepatientscannotbeclearlyclassi?edashavingtype1ortype2diabetes.Clin-icalpresentationanddiseaseprogressionvaryconsiderablyinbothtypesofdiabe-tes.Occasionally,patientswhootherwisehavetype2diabetesmaypresentwithke----本文来源于网络，仅供参考，勿照抄，如有侵权请联系删除---toacidosis.Similarly,patientswithtype1diabetesmayhavealateonsetandslow(butrelentless)progressiondespitehav-ingfeaturesofautoimmunedisease.Suchdif?cultiesindiagnosismayoccurinchil-dren,adolescents,andadults.Thetruediagnosismaybecomemoreobviousovertime.B.DiagnosisofdiabetesRecommendationsFordecades,thediagnosisofdiabeteshasbeenbasedonplasmaglucose(PG)crite-ria,eitherfastingPG(FPG)or2-h75-goralglucosetolerancetest(OGTT)values.In11017,the?rstExpertCommitteeontheDiagnosisandClassi?cationofDiabe-tesMellitusrevise...