The American Diabetes Association (ADA) has released its Standards of Medical Care in Diabetes—2018 guideline. Among the major changes:

• Classification and diagnosis: The appropriate use of A1c testing is clarified.
• Prevention or delay of diabetes: The recommendation regarding metformin better reflects Diabetes Prevention Program data.
• Glycemic targets: CGM should be used in all adults with T1D who are not meeting glycemic targets.
• Obesity management: NADAC medication prices are included.
• Pharmacologic approaches to glycemic treatment: People with ASCVD should begin with lifestyle management and metformin, and subsequently incorporate an agent.
• CVD and risk management: All hypertensive patients with diabetes should monitor their blood pressure at home.
• Older adults: 3 new recommendations are added to highlight the importance of individualizing pharmacologic therapy in this group.
• Children and adolescents: Additional recommendations were added on T1D treatment of children/adolescents regarding intensive insulin regimens, glucose self-monitoring, CGM, and automated insulin delivery.
• Management of diabetes in pregnancy: Insulin is the preferred agent for the management of T1D and T2D in pregnancy.