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The 2025 American Diabetes Association Annual Standards of Care Update

Date: 01/24/25

The American Diabetes Association (ADA) released their 2025 Standards of Care. Below is a summary of the annual update and major revisions along with the covered services of diabetes prevention programs. Please refer to the complete Standards of Care for the entire guideline.

Meridian wants to assist providers in battling the rise in diabetes and prediabetes. With that in mind, we are pleased that services delivered by accredited Diabetes Prevention Program (DPP) providers and Diabetes Self-Management Education and Support (DSMES) providers are covered by Medicaid. Learn more.

The notable updates include the following:

  • A person-centered shared decision-making approach should guide the choice of glucose-lowering medications for adults with type 2 diabetes.

    • Use medications that provide sufficient effectiveness to achieve and maintain intended treatment goals with consideration of the effects on cardiovascular, kidney, weight, and other relevant comorbidities.

  • Guidance for treatment of metabolic dysfunction-associated steatotic liver disease (MASLD) with moderate or advanced liver fibrosis.

    • Screen adults with type 2 diabetes or with prediabetes, particularly those with obesity or other cardiometabolic risk factors or established cardiovascular disease, for their risk of having or developing cirrhosis related to metabolic dysfunction-associated steatohepatitis (MASH) using a calculated fibrosis-4 index (FIB-4) (derived from age, ALT, AST, and platelets [mdcalc.com/calc/2200/fibrosis4-fib-4-index-liver-fibrosis]), even if they have normal liver enzymes.

    • Refer adults with type 2 diabetes or prediabetes at higher risk for significant liver fibrosis (i.e., as indicated by FIB-4, liver stiffness measurement, or ELF) to a gastroenterologist or hepatologist for further evaluation and management.

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

    • In adults who are overweight or obese and have a high risk to develop type 2 diabetes, care goals should include weight loss and maintenance, minimizing the progression of hyperglycemia, and attention to reducing cardiovascular risk. 

  • The importance of meeting resistance training guidelines for those treated with weight management pharmacotherapy or metabolic surgery were emphasized.

  • Patients with diabetes should be screened for anxiety symptoms. Healthcare professionals can discuss diabetes-related worries and should consider referral to a qualified behavioral health professional for further assessment and treatment if anxiety symptoms indicate interference with diabetes self-management behaviors.

  • Older adults should be screened at least annually, for geriatric syndromes (e.g., cognitive impairment, depression, urinary incontinence, falls, persistent pain, and frailty), hypoglycemia, and polypharmacy, as they may affect diabetes management and diminish quality of life.

 

References

  1. The American Diabetes Association (ADA) 2025 Standards of Care. Accessed January 7, 2025
  2. Summary of Revisions: Standards of Care in Diabetes—2025 Diabetes Care 2025;48(Suppl. 1): S6–S13.
  3. Standards of Care in Diabetes—2025 Diabetes Care 2025;48 (Suppl. 1)