The American Diabetes Association (ADA) recently released their 2025 Standards of Care, which – for the first time – includes recommendations for CGM use in type 2 diabetes, the use of GLP-1 drugs for kidney and heart health, and more.
Each year the ADA publishes its recommendations for diabetes care based on the latest scientific research and clinical trials. The ADA recently released their 2025 Standards of Care in Diabetes, which offers comprehensive strategies for healthcare providers that go beyond blood sugar management and include screening and prevention.
The ADA calls the online guidelines a “living document” and publishes updates as new scientific evidence informs clinical practice. Below are some highlights.
- Continuous glucose monitoring. For the first time, CGM use is recommended for people with type 2 diabetes, including those who are not on insulin. Research shows CGM use can help reduce the risk of serious complications, including diabetic ketoacidosis (DKA), severe low blood sugar events, diabetes-related coma, and hospitalizations for hypoglycemia and hyperglycemia.
- GLP-1 receptor agonists. There is new guidance on the use of incretin-based medications, such as tirzepatide (Mounjaro) and semaglutide (Ozempic), emphasizing the benefits for heart and kidney health for people with type 2 diabetes. The new guidelines, do not, however, make a recommendation on the use of these medicines for type 1 diabetes.
- Recreational marijuana use. The 2025 guidelines warn against the use of cannabis for people with type 1 diabetes as studies show an increased risk of DKA. The DKA in people with type 1 diabetes who use marijuana is associated with cannabis hyperemesis syndrome, which causes severe nausea, abdominal pain, and vomiting.
- Screening for type 1 diabetes. The guidelines recommend antibody-based screening for those with a family history or known genetic risk for type 1 diabetes.
- Open-source automated insulin delivery systems. Support for open-source closed-loop systems is included. The ADA advises healthcare providers to assist patients in optimizing AID system settings to ensure safety and effectiveness.
- Artificial sweeteners. An emphasis is placed on water over non-nutritive sweeteners (artificial sweeteners) except in the short term to reduce caloric intake.
- Resistance training. Especially for those focused on weight loss, resistance or strength training (like weight lifting) two to three times a week is recommended to avoid muscle loss, improve insulin sensitivity, and maintain a healthy metabolism.
- Mental health. Routine screening is recommended for anxiety related to hypoglycemia and diabetes distress due to the burdens of care for people with diabetes, their families, and caregivers. Opportunities are presented for interventions that can help, including technology such as CGM, and counseling.
As the diaTribe staff reviews the new Standards, this story will be updated to expand on some of the guidance.