The American Diabetes Association updates the Standards of Medical Care in Diabetes annually to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of diabetes. In 2020, the American Diabetes Association made important additions to the section on pharmacologic approaches to glycemic treatment of type 2 diabetes in the Standards of Medical Care in Diabetes. On the basis of new evidence, the ADA added a recommendation on early combination therapy for type 2 diabetes to extend the time to treatment failure.
The Professional Practice Committee of the ADA is an expert committee that comprises physicians, diabetes educators, and others who have expertise in such areas as pediatric and adult endocrinology, epidemiology, public health, microvascular complications, cardiovascular risk management, preconception and pregnancy care, diabetes prevention and weight management, and the use of technology in diabetes. Recommendations are rated A , B , C , or E .
It may reduce the risk for cardiovascular events and death in persons who are overweight or obese . Long-term metformin use has been associated with vitamin B12 deficiency and worsening neuropathy .
Because of concerns that diabetes drugs might lower glucose levels but lead to adverse cardiovascular outcomes, the FDA issued guidance for industry in 2008 requiring large long-term cardiovascular outcome trials of all new medications for treating type 2 diabetes.