“The 2023 Standards of Care includes revisions to incorporate person-first and inclusive language. Efforts were made to consistently apply terminology that empowers people with diabetes and recognizes the individual at the center of diabetes care,” Nuha El Sayed, MD, MMSc, an endocrinologist and vice president of healthcare improvement at the ADA, and colleagues wrote.  

The new standards of care contain recommendations on population health, prevention, or delay of type 2 diabetes, evaluating comorbidities, behavior strategies to improve health outcomes, risk management, glycemic targets and treatment, diabetes technology, obesity and weight management, retinopathy and neuropathy, diabetes in pregnancy, and managing diabetes in the hospital. 

The 2023 Standards of Care include the following new recommendations: 

• Use of community health workers in managing diabetes and cardiovascular risk 

• Utilizing point-of-care HbA1c testing for screening and diagnosis of diabetes 

• Goal setting for glycemic control and glucose-lowering management 

• Use of intensive preventative approaches for people at high risk of diabetes 

• Regularly monitoring glucose status and promote diabetes prevention among high-risk individuals prescribed statin therapy   

• Use of sodium-glucose cotransporter 2 inhibitor to improve symptoms and quality of life for individuals with type 2 diabetes and heart failure with preserved or reduced ejection fraction 

• Lowering risk of stroke or myocardial infarction with pioglitazone in individuals with a stroke history or insulin resistance 

• Adding finerenone to treatment of individuals with type 2 diabetes and chronic kidney disease with albuminuria 

• Use of pharmacotherapy to support patient goals of weight management, minimizing hyperglycemia progression, and reducing cardiovascular risk 

• Addressing social determinants of health for “guiding design and delivery of diabetes self-management education and support” 

• Management team members using behavioral strategies to support patient goals of diabetes self-management and optimal outcomes 

• Screening for sleep health and referrals to sleep medicine or behavioral health professionals when necessary 

• Use of continuous glucose monitoring (CGM) with basal insulin, minimizing gaps in CGM use, and addressing “CGM interfering substances” 

• Individualizing of small and larger weight loss treatment goals with the aim of modifying the disease and improving long-term cardiovascular outcomes 

• Updates on the latest pneumococcal and COVID-19 vaccines  

Revisions were also added to recommendations that defined hypertension and blood pressure treatment goals to align with the latest data. 

“ADA’s mission is to prevent and cure diabetes, a chronic illness that requires continuous medical care, and the release of ADA’s Standards of Care is a critical part of that mission,” Chuck Henderson, CEO for the ADA, stated in a press release. “This year’s annual report provides necessary guidance that considers the role health inequities play in the development of diabetes, particularly for vulnerable communities and communities of color disproportionately impacted by the disease. This guidance will ensure health care teams, clinicians and researchers treat the whole person.”