Diabetes Standards of Care 2025

1.1 Ensure treatment decisions are timely, rely on evidence-based guidelines, capture key elements within the social determinants of health, and are made collaboratively with people with or at risk for diabetes and caregivers based on individual preferences, prognoses, comorbidities, and informed financial considerations. B

1.2 Align approaches to diabetes management with evidence-based care models. These models emphasize person-centered team care, integrated long-term treatment approaches to diabetes and comorbidities, and ongoing collaborative communication and goal setting between all team members and with people with diabetes. A

1.3 Care systems should facilitate in-person and virtual team-based care, include those knowledgeable and experienced in diabetes management as part of the team, and utilize patient registries, decision support tools, proactive care planning, and community involvement to meet needs of individuals with diabetes. B

1.4 Assess diabetes management, risk factors, and complications (Table 4.1) using reliable and relevant data metrics to improve processes of care and health outcomes, with attention to care costs, individual preferences and goals for care, and treatment burden. B

1.5 Health systems should adopt a culture of quality improvement, implement benchmarking programs, and engage interprofessional teams to support sustainable and scalable process changes to improve quality of care and health outcomes. A

1.6 Health systems should assess and address disparities in diabetes care and health outcomes (e.g., by stratifying clinical quality data by factors such as insurance status, race, ethnicity, preferred language for health care discussions, disability, and other social determinants of health). C (104)

1.7 During clinical encounters, assess for social determinants of health, including food insecurity, A housing insecurity, financial barriers, health insurance and health care access, environmental and neighborhood factors, and social capital/social community support, B to inform treatment decisions, with referral to appropriate local community resources.

1.8 Provide people with diabetes additional self-management support from lay health coaches, navigators, or community health workers when available. A

1.9 Consider the involvement of community health workers to support management of diabetes and cardiovascular risk factors, especially in underserved communities and health care systems. B

2.1a Diagnose diabetes based on A1C or plasma glucose criteria. Plasma glucose criteria include either the fasting plasma glucose (FPG), 2-h plasma glucose (2-h PG) during a 75-g oral glucose tolerance test (OGTT), or random glucose accompanied by classic hyperglycemic symptoms/crises (Table 2.1). B

2.1b In the absence of unequivocal hyperglycemia (e.g., hyperglycemic crises), diagnosis requires confirmatory testing (Table 2.1). B