The American Diabetes Association’s (ADA) Standards of Care in Diabetes informs health care professionals about the latest evidence for diagnosing and managing diabetes. The 2025 Standards of Care includes updates to nearly all sections, including revised recommendations for

• diabetes medications
• type 1 diabetes testing
• evidence-based eating patterns

The updated Standards of Care also includes new guidance for incorporating diabetes technology and monitoring for diabetes complications.

Below are some notable updates in this year’s Standards of Care.

Choosing diabetes medications that promote heart health

The recent guidance recommends prescribing glucagon-like peptide 1 (GLP-1) receptor agonists for people who have type 2 diabetes and chronic kidney disease to lower the risk of heart disease and protect the kidneys from more damage. For people with type 2 diabetes, obesity, and heart failure with preserved ejection fraction, consider GLP-1 receptor agonists that help manage glucose and reduce the symptoms of heart failure.

Treating adults who have type 2 diabetes or prediabetes and nonalcoholic fatty liver disease (NAFLD)

For adults with type 2 diabetes; overweight or obesity; and NAFLD, also referred to as metabolic dysfunction-associated steatotic liver disease (MASLD), the ADA recommends considering a GLP-1 receptor agonist or a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist as part of the treatment plan. These medications may be prescribed along with lifestyle changes to promote weight loss and help treat nonalcoholic steatohepatitis (NASH), also referred to as metabolic dysfunction-associated steatohepatitis (MASH).

For adults with prediabetes or type 2 diabetes and NAFLD with moderate or advanced liver fibrosis, health care professionals are encouraged to consider recommending a thyroid hormone receptor-β agonist and referring them to a gastroenterologist or hepatologist.

Using antibody-based testing to assess type 1 diabetes risk

The ADA now recommends antibody-based testing for people who do not have symptoms of type 1 diabetes but have a higher risk of developing the disease, based on a family history of type 1 diabetes or other known risk. If the antibody test is positive, health care professionals should perform a repeat antibody test within 3 months to confirm the results. A person’s risk of developing type 1 diabetes increases the more antibodies they have.

Advising evidence-based healthy eating patterns

The latest guidance emphasizes advising people with diabetes or prediabetes to follow an evidence-based healthy eating pattern. Newly added nutrition recommendations include

• incorporating plant-based protein and fiber as part of an eating pattern that includes a wide variety of healthy foods
• limiting saturated fat intake to lower the risk of developing heart disease
• drinking water instead of drinks with high-calorie or calorie-free sweeteners

This year’s Standards of Care also recommends monitoring for signs of malnutrition, especially in people who have had weight-loss surgery and those who take weight-loss medication.

For more information and resources related to the Standards of Care, visit the ADA’s Standards of Care resource page.