Every year, the American Diabetes Association (ADA) publishes the Standards of Care in Diabetes to inform health care professionals about the latest research evidence on diagnosing and managing diabetes. The 2024 Standards of Care includes revisions to nearly all sections, including updated recommendations for

• person-centered care
• obesity measurements
• weight-loss medications
• evaluation and management of comorbidities
• diabetes diagnosis and classification
• patient self-management and education

The new Standards of Care also includes detailed recommendations for specific groups of people with diabetes, such as older adults, children, adolescents, and those who are pregnant.

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

Providing individual and person-centered care

The new Standards of Care emphasizes the use of person-first, culturally sensitive, and inclusive language when talking with patients about diabetes. Considering the personal aspects of diabetes care—such as individual preferences and goals, costs and overall burden of treatment, potential barriers, and health literacy—can improve health outcomes and help patients reach their goals for managing diabetes.

Assessing obesity beyond Body Mass Index (BMI)

In addition to using BMI to diagnose obesity, this year’s Standards of Care recommends using body fat distribution measurements to help with the diagnosis. Measurements may include waist-to-hip ratio, waist circumference, and waist-to-height ratio. The ADA recommends repeating these measurements annually to guide diabetes management.

Prescribing glucose-lowering medications to patients with diabetes and overweight or obesity

For patients who have diabetes and overweight or obesity, the new guidance recommends glucagon-like peptide 1 receptor agonists (semaglutide) or dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide 1 receptor agonists (tirzepatide) to help achieve weight management goals. If these medications do not help the patient achieve their goals to manage weight, or if they are not appropriate for the patient, other obesity treatments should be considered.

Managing the risk of comorbidities

The ADA revised their recommendations for evaluating and managing the risk of diabetes comorbidities, including

• assessing bone health, including diabetes-specific risk factors for fractures, as part of routine diabetes care and treatment considerations
• recommending the COVID-19 vaccine and boosters for everyone age 6 and older, including those with diabetes
• screening for and managing liver disease in people with diabetes

The ADA also updated recommendations for managing the risk of hypoglycemia, heart disease, kidney disease, and other health conditions in patients who have diabetes.

Diagnosing and classifying type 1 diabetes

This year’s Standards of Care includes updated diagnostic criteria for type 1 diabetes to include antibody testing and a new, easy-to-follow flow chart for investigating suspected type 1 diabetes in adults.

Facilitating positive health behaviors

Health care professionals are provided with new guidance to evaluate the need for their patients to receive diabetes self-management and education at five critical times, including

• diagnosis
• if treatment goals are not being met
  
• annually
  
• if complications arise
  
• if transitions in life or treatment occur
  

Other updates on facilitating positive health behaviors include changes to the medical nutrition therapy section, which now emphasizes food-based eating styles that incorporate healthy fats and Mediterranean-style eating patterns. This year’s Standards of Care also includes an introduction to religious and time-restricting fasting as well as recommendations for sleep health habits and mental health screening.

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