The American Diabetes Association has released its 2025 Standards of Care, with updates to diabetes management guidelines across technology integration, obesity treatment, cardiovascular care, and psychosocial screening.
The 2025 Standards of Care emphasized person-centered care and inclusive language. Key changes included the expanded use of automated insulin delivery (AID) systems, updated medication protocols for type 2 diabetes, and new terminology for metabolic dysfunction–associated steatotic liver disease (MASLD). Treatments included glucagon-like peptide (GLP)-1 receptor agonists and thyroid hormone receptor–β agonists for certain patients.
For the first time, the American Geriatrics Society endorsed guidelines for older adults. The Obesity Society and American College of Cardiology continued their respective endorsements of the obesity and cardiovascular disease sections. Updates also addressed malnutrition screening for weight loss and long-term pharmacotherapy for maintaining weight loss.
Hospital glycemic targets were updated to 140 to 180 mg/dL for critically ill patients and 100 to 180 mg/dL for non–critically ill patients. New protocols addressed diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) prevention and management. Recommendations also supported maintaining insulin pumps or AID systems during hospitalization under clinical guidance.
Guidance on religious fasting included using the Diabetes and Ramadan International Alliance framework for risk stratification and medication adjustments. For pregnancy, AID systems were recommended if they featured pregnancy-specific glucose goals, while dilated eye exams were advised both preconception and during the first trimester.
Psychosocial care recommendations included annual screenings for diabetes distress and anxiety as well as guidance for managing hypoglycemia-related fears. Cardiovascular updates highlighted new algorithms for cholesterol-lowering therapy, peripheral artery disease screening, and GLP-1 receptor agonists for heart failure with preserved ejection fraction (HFpEF).
The complete guidelines included 17 sections covering all aspects of diabetes management and remained the primary clinical practice guideline for the upcoming year.