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La diabetes mellitus es una enfermedad metabólica crónica que se caracteriza por niveles elevados de glucosa en la sangre debido a una producción insuficiente de insulina o una resistencia a la insulina en el cuerpo.

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Existen principalmente tres tipos de diabetes mellitus: Tipo 1, Tipo 2 y Diabetes Gestacional. Cada uno tiene diferentes causas y tratamientos.

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Los síntomas comunes de la diabetes incluyen sed excesiva, micción frecuente, hambre extrema, pérdida de peso inexplicable, fatiga y visión borrosa.

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La diabetes puede llevar a complicaciones graves como enfermedades del corazón, problemas renales, daño a los nervios y retinopatía diabética.

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La Asociación Americana de Diabetes (ADA) ha publicado su guía actualizada para el año 2024, proporcionando nuevas recomendaciones para el manejo y tratamiento de la diabetes.

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Standards of Care in Diabetes

The Standards of Care in Diabetes ( Standards of Care) includes all of current clinical practice recommendations of the American Diabetes Association (ADA) and is intended to provide clinicians, researchers, policy makers, and other individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.

Updates to the Standards of Care in 2024

Tune in to ADA's Chief Scientific and Medical Officer, Robert Gabbay, MD, PhD, as he gives an overview of the latest updates to the Standards of Care in Diabetes.

Standards of Care App

Get the Standards of Care App in the App Store for iOS or Google Play for Android for up-to-date recommendations and interactive tables and algorithms.

App Store for iOS Google Play for Android

Standards of Care: Slide Deck

This comprehensive slide deck of ADA's 2024 Standards of Care (.PPTX) contains content created, reviewed, and approved by the ADA. You are free to use the slides in presentations without further permission as long as the slide content is not altered in any way and appropriate attribution is made to the American Diabetes Association (the ADA name and logo on the slides constitutes appropriate attribution).

Permission is required from the Association for any commercial use or for reproduction in any print materials permissions@diabetes.org.
Abridged Standards of Care: Slide Deck

The American Diabetes Association truly welcomes your comments and suggestions regarding the Standards of Care in Diabetes.

Download and complete this form to submit a proposal for an ADA Publication or Conference.

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Skip to Main content Home Standards of Care in Diabetes The Standards of Care in Diabetes ( Standards of Care) includes all of current clinical practice recommendations of the American Diabetes Association (ADA) and is intended to provide clinicians, researchers, policy makers, and other individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care.

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Las guías de la ADA 2024 hacen hincapié en nuevas terapias farmacológicas y tratamientos personalizados para mejorar el control de la glucosa en pacientes con diabetes mellitus.

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There are approximately 425 million people worldwide with diabetes. Approximately 75 million of these inject themselves with insulin daily. Now they may soon have a new alternative to syringes or insulin pumps. Scientists have found a new way to supply the body with smart insulin.

The new insulin can be eaten by taking a capsule or even better, within a piece chocolate.

Inside these we find tiny nano-carriers to which the insulin is encapsulated. The particles are 1/10,000th the width of a human hair and so small that you cannot even see them under a normal microscope.

"This way of taking insulin is more precise because it delivers the insulin rapidly to the areas of the body that need it most. When you take insulin with a syringe, it is spread throughout the body where it can cause unwanted side effects," explains Professor Peter McCourt at UiT Norway's Arctic University. He is one of the researchers behind the study.

The research was recently published in Nature Nanotechnology.
Delivered to the liver
It was researchers at the University of Sydney and Sydney Local Health District who, in collaboration with UiT, discovered many years ago that it was possible to deliver medicines via nano-carriers to the liver. The method has then been further developed in Australia and in Europe.

Many medicines can be taken by mouth, but until now people have had to inject insulin into the body. McCourt explains that the problem with insulin with a nano-carrier is that it breaks down in the stomach and thus does not get to where it is needed in the body. This has been a major challenge for developing a diabetes medicine that can be taken orally.

But now the researchers have solved this challenge.

"We have created a coating to protect the insulin from being broken down by stomach acid and digestive enzymes on its way through the digestive system, keeping it safe until it reaches its destination, namely the liver," says McCourt, who is a liver biologist.

The coating is then broken down in the liver by enzymes that are active only when the blood sugar levels are high, releasing the insulin where it can then act in the liver, muscle, and fat to remove sugar from the blood.

"This means that when blood sugar is high, there is a rapid release of insulin, and even more importantly, when blood sugar is low, no insulin is released," says Nicholas J. Hunt at the University of Sydney who, together with Victoria Cogger, leads the project.

He explains that this is a more practical and patient-friendly method of managing diabetes because it greatly reduces the risk of a low blood sugar event occurring, namely hypoglycemia and allows for the controlled released of insulin depending on the patient's needs, unlike injections where all the insulin is released in one shot.
Fewer side effects
The new method works similarly to how insulin works in healthy people. The pancreas produces insulin which first passes through the liver where a large portion of it is absorbed and maintains stable blood sugar levels. In the new insulin method, the nano-carrier releases insulin in the liver, where it can be taken up or enter the blood to circulate in the body.

"When you inject insulin under the skin with a syringe, far more of it goes to the muscles and to adipose tissues that would normally happen if it was released from the pancreas, which can lead to the accumulation of fats. It can also lead to hypoglycemia, which can potentially be dangerous for people with diabetes.

With the new method, there will be fewer such side effects.

In addition, you do not need to stab yourself with a needle and you can take the medicine you need in a slightly more discreet way. Also, this form of insulin does not need to be refrigerated.
Tested on baboons
The oral insulin has been tested on nematodes, on mice and rats. And lastly, the medicine has now been tested on baboons in the National Baboon Colony in Australia.

"In order to make the oral insulin palatable we incorporated it into sugar-free chocolate, this approach was well received" says Hunt.

He says that 20 baboons have taken part in this study. When they received the medicine, their blood sugar was lowered.

The baboons were normal, healthy baboons, but the oral insulin have also been tested on mice and rats that actually have diabetes. The mice and rats did not have low blood sugar events (hypoglycemia), gain weight or fat accumulation in the liver overcoming current challenges with injectable and other oral insulins.

What remains now is to test the new method on humans.
Ready for use in 2-3 years
"Trials on humans will start in 2025 led by the spin out company Endo Axiom Pty Ltd. Clinical trials are performed in 3 phases; in the phase I trial we will investigate the safety of the oral insulin and critically look at the incidence of hypoglycemia in healthy and type 1 diabetic patients. Our team is very excited to see if we can reproduce the absent hypoglycemia results seen in baboons in humans as this would be a huge step forward. The experiments follow strict quality requirements and must be carried out in collaboration with physicians to ensure that they are safe for the test subjects" says Hunt.

"After this phase I we will know that it is safe for humans and will investigate how it can replace injections for diabetic patients in phase 2 trials," says the researcher.

The researchers hope that the new medicine can be ready for use by everyone in 2-3 years.

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diabetes; hypertension; liver disease; hormone disorders; medical devices; diet and weight loss; diseases and conditions; birth control

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New medicine can create a new life for diabetes patients -- without needles!

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Researchers have found a new way to supply the body with insulin. The medication that can be taken orally has already been tested on baboons, in which it was found to lower the blood sugar levels without causing hypoglycemia. The new insulin is ready to be tested on humans in 2025.

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La actualización de 2024 también destaca el uso de tecnologías avanzadas como monitores continuos de glucosa (CGMs) y bombas de insulina para una gestión más eficaz de la diabetes.

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Diabetes Technology Society (DTS), led by Dr. David Klonoff, and Kitalys Institute, led by Dr. Alexander Fleming, are partnering to host a virtual webinar about "Advanced Glycation Endproducts (AGEs)." See more at https://diabetestechnology.org/age

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Diabetes Technology Society (DTS), led by Dr. David Klonoff, and Kitalys Institute, led by Dr. Alexander Fleming, are partnering to host a virtual webinar about "Advanced Glycation Endproducts (AGEs)." See more at https://diabetestechnology.org/age

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Importancia del Estilo de Vida Saludable

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Importancia del Estilo de Vida Saludable

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Las guías enfatizan la importancia de mantener un estilo de vida saludable, incluyendo dieta balanceada y ejercicio regular, como parte integral del manejo de la diabetes.