Diabetes Management

Current standards describe diabetes care as lifelong, team‑based, and person‑centered, not just a focus on an A1C lab value. Good management now also means lowering heart and kidney risks, supporting mental health, and fitting treatment into real life.

Guidelines emphasize diabetes self‑management education and support (DSMES) at key times: at diagnosis, yearly check‑ins, when control slips, and during big life or treatment changes. Digital tools, telehealth visits, and virtual classes are highlighted to reach people who live far from clinics or have busy schedules.

The 2025 standards shift from strict calorie counting to **high‑quality, sustainable eating patterns**—such as plant‑based or Mediterranean‑style diets with fewer ultra‑processed foods. Non‑nutritive sweeteners can replace sugar short term to cut calories and carbs, but water is the preferred drink.

Physical activity combines regular aerobic movement (like brisk walking) with resistance/strength training, which is especially important if you use weight‑loss medications or had metabolic surgery. Sleep is now listed as a core pillar of diabetes care, on par with food and exercise, because poor sleep worsens insulin resistance and appetite.

Continuous glucose monitoring is now **strongly recommended for many people with type 2 diabetes**, including some not using insulin, because it shows trends and time‑in‑range, not just single numbers. CGM data can link specific meals, stress, or exercise to your glucose response and help adjust behavior in real time.

The guidelines reinforce the use of mobile apps, digital coaching, and connected devices as part of Diabetes Self‑Management Education and Support. Automated insulin delivery systems that combine pumps and CGMs are increasingly used in type 1 diabetes and some insulin‑treated type 2 cases.

For type 2 diabetes, 2025 guidance favors early use of agents that hit **multiple targets**: lower glucose, protect the heart and kidneys, and support weight loss when needed. GLP‑1 receptor agonists, SGLT2 inhibitors, and newer dual GIP/GLP‑1 agonists are highlighted for their cardiovascular, kidney, and weight benefits.

In people with chronic kidney disease and diabetes, SGLT2 inhibitors are emphasized even when glucose is reasonably controlled, because they slow kidney decline and lower heart‑failure risk. Nonsteroidal mineralocorticoid receptor antagonists, such as finerenone, are recommended for persistent albuminuria despite standard therapy.

Blood sugar, blood pressure, and cholesterol goals are now individualized, especially for older adults or those at high risk of hypoglycemia. When lows are frequent, de‑intensifying therapy and slightly relaxing A1C targets is recommended to improve safety and quality of life.

Guidelines stress addressing weight stigma, cost, and access while choosing therapies. Regular follow‑up—often supported by telemedicine and remote monitoring—helps adjust treatment as life, health status, or personal priorities change.