Framework for Making Systems Changes

Example of Recommendations

The following recommendations come from the American Diabetes Association Position Statement on the Standards of Medical Care for Patients with Diabetes Mellitus and illustrate the way evidence ratings may appear in an evidence-based report.²

A-Level evidence

• Lowering A1C has been associated with a reduction of microvascular and neuropathic complications of diabetes. (A)

B-Level evidence

• The A1C goal for patients in general is an A1C goal of <7%. (B)
• Aggressive glycemic management with insulin may reduce morbidity in patients with severe acute illness, perioperatively, following myocardial infarction, and in pregnancy. (B)

Expert consensus

• The A1C goal for the individual patient is an A1C as close to normal (<6%) as possible without significant hypoglycemia. (E)
• Less stringent treatment goals may be appropriate for patients with limited life expectancies, in the very young or older adults, and in individuals with comorbid conditions. (E)

-Return to the Top-
-Return Home-

Continue to Evidence-Based Medicine: Numeric Presentation of Results