The American Diabetes Association (ADA) has released its updated Standards of Care in Diabetes for 2025, emphasizing person-centered care, the integration of multidisciplinary teams, and the expanded focus on co-existing conditions like obesity, cardiovascular disease, and chronic kidney disease. These updates reflect the rapidly evolving landscape of diabetes care, incorporating new research, technologies, and treatment strategies.
In the latest standards, the ADA advocates for a more comprehensive, team-based approach to managing diabetes. The guidelines stress the importance of addressing the health of the whole person, not just their diabetes. This includes tackling related conditions such as obesity and metabolic disorders like metabolic dysfunction-associated steatotic liver disease (MAFLD). The ADA calls for healthcare professionals to use a collaborative team approach, involving specialists such as diabetes care experts, primary care providers, nurses, dietitians, pharmacists, behavioral health specialists, and even dentists.
A notable addition to this year’s guidelines is a specific focus on overweight and obesity management for patients with type 2 diabetes and MAFLD. The updated standards encourage healthcare providers to recommend lifestyle modifications, including a structured nutrition and physical activity plan. Glucagon-like peptide-1 (GLP-1) receptor agonists are highlighted as effective tools in this management plan, offering benefits beyond diabetes control, including weight loss, cardiovascular health, and liver function improvements. These medications are recommended to complement lifestyle interventions and may be used in combination with other treatments such as pioglitazone.
Section 5 of the new guidelines emphasizes the importance of diabetes self-management education and support (DSMES). The ADA recommends that patients participate in DSMES programs to improve their decision-making skills, self-care behaviors, and collaboration with healthcare providers. DSMES programs can be customized to meet individual needs, with options for digital or telehealth delivery, making them more accessible and flexible for patients.
The role of nutrition, weight management, and behavioral therapy is also highlighted, underscoring their critical importance in diabetes care. For the first time, sleep is included as a key factor in diabetes prevention and management, with the ADA recognizing its impact on both prediabetes and type 2 diabetes. The guidelines note that insufficient or poor-quality sleep can significantly increase the risk of developing type 2 diabetes, with sleep duration and timing playing a crucial role. Patients who sleep less than 6 hours or more than 9 hours a night are at greater risk, while those with poor sleep quality may face up to an 84% increased risk.
The ADA also recommends additional measurements beyond the traditional body mass index (BMI) for diagnosing obesity, such as waist circumference and waist-to-hip ratios. These measurements should be regularly monitored, with weight management interventions assessed at least every three months to ensure long-term success.
In addition to these major updates, the ADA’s 2025 standards also reflect minor clarifications and new evidence, along with language changes that prioritize person-first, inclusive terminology. The goal is to continue empowering individuals with diabetes and place them at the center of their own care.
These updates to the Standards of Care in Diabetes aim to provide a more holistic and patient-centered approach to managing diabetes, ensuring better outcomes through comprehensive care strategies that address the individual’s full range of health needs.
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