ADA 2025 Standards: Prevention or Delay of Diabetes and Comorbidities
The American Diabetes Association’s 2025 *Standards of Care in Diabetes* dedicates a key section to preventing or delaying type 2 diabetes and associated comorbidities, highlighting lifestyle management, screening protocols, and targeted pharmacotherapy.
Key Highlights:
- Annual Monitoring: Individuals with prediabetes should be monitored at least annually (or more frequently based on risk) using A1C, fasting glucose, or OGTT to detect progression early.
- Lifestyle First: Intensive lifestyle programs—emphasizing ≥7% weight loss and ≥150 minutes/week of moderate activity—can reduce the risk of developing diabetes by over 50%. Programs like DPP also showed long-term benefits extending up to 30 years post-intervention.
- Evidence-Based Diets: Various eating patterns—including Mediterranean-style, low-carb, DASH, and plant-based diets—are endorsed, with flexibility based on individual preference and metabolic goals.
- Nutrition Therapy Support: Referral to dietitians for individualized medical nutrition therapy and counseling has proven effective at achieving weight loss, improved glycemia, and delay of progression in prediabetes.
- Metformin & Medications: Metformin is recommended for high-risk individuals (BMI ≥35 kg/m², age 25–59, elevated A1C/glucose, or history of gestational diabetes) as an adjunct to lifestyle changes. Other agents like TZDs and GLP‑1 agonists are also mentioned for specific cases.
- Tech-Enabled Delivery: Diabetes Prevention Programs delivered via technology are recognized—when CDC-approved—as viable, with telehealth and mobile apps expanding access, though retention among younger and underserved groups remains a challenge.
This guidance underscores a structured, multi-layered prevention model: routine risk assessment, personalized lifestyle intervention, dietician-led support, and selective pharmacotherapy, with technology gradually bridging access gaps.
Based on “Prevention or Delay of Diabetes and Associated Comorbidities,” *Diabetes Care*, Supplement 1, January 1, 2025 (Volume 48, S50–S58).
Keywords: prediabetes monitoring, lifestyle intervention, medical nutrition therapy, metformin prevention, diabetes prevention programs