Diabetes is a serious disease that can cause numerous health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. As of 2014, 29.1 million people in the United States, or 9.3 percent of the population, had diabetes, according to the CDC data. Diabetes is also the seventh leading cause of death in the United States.
Type 2 is the most common type of diabetes, accounting for about 90% to 95% of all diagnosed cases of diabetes. Type 2 diabetes mostly affects middle-aged and older people, although it can be developed at any age, even during childhood.
While people with type 1 diabetes need to take insulin for life to survive, people with type 2 diabetes have lots other options to manage their diabetes and prevent or delay complications, including healthy diet, regular physical activity, and medicines to lower blood sugar.
Diabetes patients need to work closely with their healthcare providers, who are expected to provide comprehensive information about diabetes, including support, checkups, medications, etc.
Healthcare providers decide if patient is suitable for medications, also which drugs are right for them, as well as how often they should take it. Therapy usually starts with oral medications, such as metformin. But, diabetes medications sometimes stop working, and healthcare providers should know when to adjust doses or switch to new medication.
The American Association of Clinical Endocrinologists (AACE), in conjunction with the American College of Endocrinology (ACE), is publishing the Comprehensive Diabetes Management Algorithm each year, as a clinical guide to help healthcare professionals manage the care of patients with type 2 diabetes.
They also made their algorithm available for Android and iOS devices in a form of mobile app, which is available for free.
Today, I'm reviewing 2016 AACE Diabetes Algorithm app (still the most current on mobile stores) that introduced new treatments for diabetes, diabetes management tactics, and vital clinical data, including therapy optimization based on lifestyle, taking complications into consideration when treating overweight patients, safety-rank for anti-diabetic treatment, etc.
It should be noted that few days ago, AACE published new updated guidelines for 2017, which emphasize obesity as one of the underlying risk factors for type 2 diabetes and its microvascular complications, so we can expect that the app will be also updated sometime this year.
AACE Diabetes Algorithm app is basically a support tool to help make evidence-based decisions about individual patient care. It's a fairly simple app in terms of functionality and design, as you may see once you started the app, but it provides comprehensive information in very detailed guidelines, each made as easy-to-follow decision tree.
The app opens to a home screen that features table of contents, including lifestyle therapies, complications-concentric care for patients with obesity, prediabetes, goals for glycemic control, glycemic control algorithm, adding/intensifying insulin, atherosclerotic cardiovascular disease (ASCVD) risk factor modifications, profiles of antidiabetic medication, and principles.
Tapping on any of the main features, opens a corresponding algorithm. For example, lifestyle therapies algorithm provides risk stratification by burden of obesity and related complications, while the following algorithm focuses on care of overweight/obese patients, with or without complications.
One of the biggest problems in U.S. is also prediabetes. It is estimated that more than a third of adults in U.S., or around 86 million, have prediabetes – a condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as diabetes.
People with prediabetes have an increased risk of type 2 diabetes, heart disease, and stroke, but 90% of them don't know they have this condition. AACE Algorithm app also includes prediabetes algorithm that provides guidelines for treatment of patients who have borderline diabetes in an easy-to-comprehend format.
Other algorithms include glycemic control with individual goals based on higher or lower hemoglobin A1C level, recommendations on starting basal insulin or intensifying the therapy by adding prandial insulin.
Also, the app recommends ASVCD risk factor modifications for dyslipidemia and hypertension, for example considering aspirin therapy in women aged greater than 50 years, or adding ezetimibe to moderate-intensity statin therapy for cardiovascular benefits.
The app also gives other general recommendations, for example that any patient at 45 years of age should be tested regardless of their weight, that all type 2 diabetes patients should be initiated on metformin unless contraindicated or if they are intolerant to the medication, while patients with newly diagnosed type 2 diabetes and elevated blood glucose levels or A1C should be considered for insulin therapy.
AACE Algorithm app makes all these complex diabetes-related decisions much easier, primarily due to easy-to-use interface and detailed evidence-based recommendations presented in an intelligible format, and updated regularly.
It is a definitive, point-of-care tool for all healthcare providers engaged in the treatment of patients who are at risk for diabetes or who have already developed it.
Benefit: Physicians, endocrinologists and other health care providers how to treat patients with type 2 diabetes and prediabetes