Multiple Chronic Conditions Blog

Controversial Clinical Guideline Updates 2018

Tuesday, 22 January 2019 08:34 / by Dr Kim Kuebler
American Diabetes Association Type 2 Diabetes

2018 relaxed Hemoglobin A1c criteria with a focus on patient-centered care. Focus on reducing cardiovascular risk management. Online updates throughout the year based upon FDA approved therapies.

American Heart Association/American College of Cardiology Hypertension

Released in 2017 and debated throughout 2018. Altered from the 8th Joint National Committee (JNC-8), who departed from historical blood pressure norms by recommending systolic pressure increase to 150 mm/Hg. AHA/ACC lowered the threshold to >130/80. First-line therapy for hypertension is lifestyle modification (weight loss, healthy diet, reduced alcohol intake and increased physical activity).

American College of Cardiology/American Heart Association Cholesterol

2018 more personalized approach, LDL above 70 mg/dl require aggressive management. Consider using non-statin therapies including ezetimibe and PCSKG inhibitors.

Global Initiative for Chronic Obstructive Lung Disease (GOLD)

International COPD guidelines since 2001, updated annually. Recommend long-acting bronchodilators vs. corticosteroids to prevent COPD exacerbations. Eosinophil count is used to determine therapy.

Vitamin D/Calcium Supplementation

Does not prevent risk of fracture, improve bone density or reduce cardiovascular risk factors. Calcium supplementation has minimal effect on bone and may increase cardiovascular disease

Fish Oil Supplementation

Does not reduce cardiovascular risk factors or reduce cholesterol. Does not prevent cancer

MULTIPLE CHRONIC CONDITIONS RESOURCE CENTER WILL CONTINUE TO PROVIDE CURRENT UPDATES ON POLICY AND PRACTICE TO MEET THE CARE NEEDS
OF THE LARGEST U.S. PATIENT POPULATION

Dr Kim Kuebler

Dr Kim Kuebler

Dr. Kim Kuebler, DNP, APRN, ANP-BC, Founder and Director of Multiple Chronic Conditions Resource Center, CEO Advanced Disease Concepts LLC, Savannah, GA. Primary Care Provider, Veterans Affairs Southern Oregon Rehabilitation Center & Clinics, Grants Pass Community-based Outpatient Clinic