The 2025 ADA guidelines introduce key updates that reflect the growing need for personalized, comprehensive diabetes care to address a broader patient population. Among the most notable changes, continuous glucose monitoring (CGM) is now recommended beyond insulin-treated individuals, particularly for adults with type 2 diabetes who are on glucose-lowering therapies who may benefit from real-time glucose insights to improve glycemic control and reduce variability. The guidelines also offer strategies to navigate medication shortages, incorporate additional classes of glucose-lowering agents with cardiovascular and renal benefits, and maintain weight-loss pharmacotherapy beyond initial goals to support long-term metabolic health.
As medication selection continues to evolve, the guidelines emphasize a patient-centered approach that prioritizes cardiovascular, renal, and metabolic health. Beyond glucose lowering, clinicians are encouraged to consider therapy combinations with demonstrated benefits in reducing cardiovascular risk, slowing kidney disease progression, and supporting sustained weight management. New cardiovascular findings reinforce the role of SGLT2 inhibitors, expanding their use in both preserved and reduced ejection fraction heart failure. The guidelines likewise encourage careful patient selection and ongoing monitoring for adverse effects. Additionally, lifestyle-based interventions such as structured nutrition plans, physical activity, and behavioral strategies remain core pillars in achieving metabolic targets.
How will these updates shape your management strategies for adults with type 2 diabetes, particularly in integrating advanced monitoring tools and optimizing heart and kidney protection?
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Paul Kuryla, THOMAS MEMORIAL HOSPITALApril 21, 2025CGMs , GLPs
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Muhammad NawazApril 21, 2025CGMs are the biggest revolution in the management of Diabetes and with their biofeedback has resulted in positive outcomes with behavior modification diet and exercise and now with OTC avaialability of them has gone to a different dimension altogether with patient being incharge of their glycemic control and gives the providers better and timely management and trouble shooting in optimal control at the same time SGLT-2 inhibitors initially introduced as diabetic meds have become the standard of care in CAD , CHF and CKD patients So the question we have to ask ourselves in management of T2D , CKD and CAD and CHF pts is why they can not be on SGLT-2 inhibitors as in these pts optimal consdierations should be given to get the pts on these meds ! great time to practice diabetology and for Primary Care with these meds and the tools their role has become more important and effective also minmizing the referrals to endo and have the opportunity to have the broad spectrum perspective of Cardiac and Renal Health as well !!!
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Daniel KatselnikApril 21, 2025more data on benefit in type 1 as well
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Richard Moro, HEALTHCALL MEDICAL CENTER,LLCApril 18, 2025sglt2 and kerendia are excellent for stopping microalbunia and ckd
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Jorge OsorioApril 15, 2025SGLT-2 inhibitors are medication with multiple indications, prevent progression ckd, decrease the risk of cardiovascular events, the use of uACR and gfr are improtant in the monitoring ckd, adjust treatment .
