CMHC Pulse Blog

Last month, the 2025 American Diabetes Association (ADA) guidelines were introduced, providing updates for diagnosing and managing diabetes and prediabetes. These new guidelines offer actionable, evidence-based recommendations to improve care delivery. 

1. ADA Updates: Continuous Glucose Monitoring (CGM) for Type 2 Diabetes on Glucose-Lowering Agents 

The ADA now recommends considering CGM for adults with type 2 diabetes who are using glucose-lowering agents other than insulin. CGM offers real-time blood sugar insights for better decision-making, enhancing glycemic control, and reducing complications. 

2. ADA Updates: Navigating Medication Shortages 

For the first time, the guidelines provide specific actions for addressing medication shortages. This ensures patients have contingency plans to maintain effective diabetes management during periods of unavailability.

3. ADA Updates: Expanded Role of GLP-1 Receptor Agonists 

Beyond their benefits for weight loss, GLP-1 receptor agonists are shown to have heart and kidney health advantages. Dual GIP and GLP-1 receptor agonists are also recommended for perioperative care in appropriate patients. 

4. ADA Updates: Weight Management Pharmacotherapy Beyond Goals 

Guidance for patients achieving weight loss goals with pharmacotherapy to continue treatment to maintain metabolic benefits and prevent weight regain. 

5. ADA Updates: New Guidance on MASLD Treatment 

For individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) and moderate or advanced liver fibrosis, thyroid hormone receptor-beta agonists may be recommended. 

6. ADA Updates: Presymptomatic Type 1 Diabetes Screening 

The ADA emphasizes antibody-based screening for presymptomatic type 1 diabetes, especially in individuals with a family history or known genetic risk, to facilitate early intervention. 

7. ADA Updates: Cannabis Use Risks 

New warnings address the risks of recreational cannabis use for individuals with diabetes, particularly those at risk for diabetic ketoacidosis (DKA). 

8. ADA Updates: Updates for Pregnancy Care 

The guidelines include key updates on medications potentially harmful during pregnancy and provide guidance on modifying care plans to ensure maternal and fetal safety. 

9. ADA Updates: Expanded Nutrition Guidance 

• Plant-Based Proteins and Fiber: Emphasis on evidence-based eating patterns incorporating plant-based proteins and fiber while balancing calories and metabolic goals. 

• Beverage Guidance: Recommends prioritizing water over sweetened beverages and using nonnutritive sweeteners in moderation as a short-term strategy to reduce calorie and carbohydrate intake. 

10. ADA Updates: Physical Activity and Resistance Training 

Meeting resistance training guidelines is emphasized, particularly for patients using weight management pharmacotherapy or recovering from metabolic surgery. 

11. ADA Updates: Guidance on DKA and HHS Management 

New recommendations address the management of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) in outpatient and inpatient settings. 

12. ADA Updates: Screening for Emotional Health 

Updates include improved screening approaches for fear of hypoglycemia, diabetes distress, and anxiety to enhance overall patient well-being. 

13. ADA Updates: Optimized Care for Older Adults 

The guidelines now provide tailored recommendations for diabetes management in older adults, accounting for age-related factors and co-occurring health conditions. 

Why These Changes Matter 

These updates aim to: 

• Empower patients and providers with better tools like CGM. 

• Expand the therapeutic scope of GLP-1 receptor agonists for broader health benefits. 

• Address evolving challenges like medication shortages and cannabis use risks. 

• Provide holistic and personalized care for diverse patient populations. 

Explore the complete 2025 ADA Standards of Care in Diabetes to learn more about improving outcomes and care quality for individuals with diabetes.