American Diabetes Association Unveils Standards of Care in Diabetes-2025

The American Diabetes Association has released the Standards of Care in Diabetes-2025, the authoritative guide for evidence-based diagnosis and management of diabetes and prediabetes. Grounded in the latest scientific research and clinical trials, this comprehensive resource provides strategies for diagnosing and treating diabetes in both youth and adults, approaches to prevent or delay type 2 diabetes and related conditions such as obesity, and care recommendations aimed at improving health outcomes.

The latest ADA guidelines combine comprehensive, evidence-based recommendations for diabetes care with actionable guidance to enable health care professionals provide the best care possible for those living with diabetes,” said Nuha El Sayed, MD, MMSc, the ADA’s senior vice president of health care improvement.

Notable updates to the Standards of Care in Diabetes-2025 include:

• Consideration of continuous glucose monitor (CGM) use for adults with type 2 diabetes on glucose-lowering agents other than insulin.

• Guidance on actions to take during circumstances of medication unavailability, such as medication shortages. 

• Additional guidance on the use of GLP-1 receptor agonists beyond weight loss for heart and kidney health benefits.

• Guidance on continuation of weight management pharmacotherapy beyond reaching weight loss goals.

• Guidance for treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) with moderate or advanced liver fibrosis using a thyroid hormone receptor-beta agonist.

• Emphasis on the use of antibody-based screening for presymptomatic type 1 diabetes in those who have a family history or known genetic risk.

• Guidance on the use of recreational cannabis for type 1 diabetes and those with other forms of diabetes at risk for diabetic ketoacidosis (DKA).

• Key updates highlighting potentially harmful medications in pregnancy and guidance for appropriately modifying the care plan.

• Expanded nutrition guidance to encourage evidence-based eating patterns, including those incorporating plant-based proteins and fiber, that keep nutrient quality, total calories, and metabolic goals in mind.

The ADA updates its Standards of Care annually through the work of its Professional Practice Committee (PPC), a group of global experts from diverse professional disciplines. The PPC includes physicians, nurse practitioners, certified diabetes care and education specialists, registered dietitian nutritionists, pharmacists, and methodologists, each bringing expertise in various related fields. The 2025 Standards of Care has received endorsements from the American College of Cardiology (Section 10), the American Geriatrics Society (Section 13), the American Society of Bone and Mineral Research (Bone Health, Section 4), and The Obesity Society (Section 8).

Key updates include-

• Encouraging water intake over both nutritive and nonnutritive sweetened beverages, with a recommendation to use nonnutritive sweeteners over sugar-sweetened products in moderation and for short-term calorie and carbohydrate reduction.

• Highlighting the importance of adhering to resistance training guidelines for individuals undergoing weight management pharmacotherapy or metabolic surgery.

• Providing guidance for managing diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) in both outpatient and inpatient settings.

• Updating screening protocols to address fear of hypoglycemia, diabetes distress, and anxiety.

• Refining strategies to improve diabetes care delivery for older adults.

• Offering guidance on the use of GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists in perioperative care settings.

“Improving the lives of people affected by diabetes is a key part of the ADA’s mission. The Standards of Care offers the trusted support needed for people living with diabetes and those caring for them to manage the disease and thrive until we find a cure,” said Charles “Chuck” Henderson, the ADA’s chief executive officer.

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